The Assembly met at noon (Mr Speaker in the Chair).
Members observed two minutes’ silence.

Assembly Business

Mr Speaker: Following last Monday’s Question Time, Mr Derek Hussey raised a point of order seeking clarification on the convention adopted by the Speaker or Deputy Speaker in choosing supplementary questioners.
The choice of supplementary questions is at the discretion of the Speaker or Deputy Speaker, and there are many matters to be taken into account. I have discussed the matter on several occasions with the Business Committee. There is the need to balance satisfactory exploration of the issue with the need for Ministers to answer as many tabled questions as possible in the time available.
Aside from the question from the Member who tabled the question, I shall ordinarily call a maximum of two further supplementary questions. I do that to ensure that Members who take the trouble to table questions are not excessively disadvantaged by other Members who request to ask supplementary questions. I shall not generally call more than one Member from any party to pose a question or supplementaries to it. In addition, I shall not call a Member to pose a supplementary question who already has a listed question on the Notice Paper that may be reasonably expected to be reached by the Minister during Question Time.
There are many other matters to be taken into account, such as the preference accorded to Chairpersons and Deputy Chairpersons of Committees whose Minister is answering the particular questions, the preference accorded to other Members in a constituency, when a constituency is the subject of a question, and the recognition of Members who have a standing interest in the issue to hand.
With only two supplementary questions and at least five major sections of the House, if not more, it is clear that on many occasions there will not be a balance within a question. However, the Speaker or Deputy Speaker does try, as far as possible, to maintain a balance over time. I have studied Hansard in respect of this period of questions, and I am content that, as far as was reasonably possible, the proper conventions were followed in questions to the Minister. I hope that this assists in clarifying the matter for the Member and the House.

Mr Derek Hussey: On a point of order, Mr Speaker. The Minister mentioned people who had a relevant interest in the issue. However, two members of the Committee for Regional Development were not called to speak. In spite of the cross-community nature of the Assembly, no one was called to speak from this side of the House.

Mr Speaker: I have to say that I think the Member is picking and choosing; he needs to be careful that he is not challenging the Chair. The question of the occupant of the Chair at any time is not a matter of issue. The conventions are clear, and Members will see that the matter was properly attended to. I hope that the Member will read all of what I have said, not just the bits of it that happen to suit that particular question for himself.

Public Petition: Transfer of Omagh Permit Office

Mr Speaker: Mr Hussey has begged leave to present a public petition in accordance with Standing Order 22.

Mr Derek Hussey: I beg leave to present a petition on behalf of 91 farmers from West Tyrone under Standing Order 22. I acknowledge the work of Omagh district councillor, Bert Wilson, who is a farmer and a signatory of the petition. The petition is in support of the transfer of the Department of Agriculture and Rural Development permit office from Sperrin House, Omagh, to the agricultural mart at Drumquin Road, Omagh. The concern of the petition is further heightened by the closure of parking facilities at the former Omagh Showgrounds site, thus increasing the difficult access problems at the current location of the Department’s permit office and the problems associated with parking in Omagh generally.
Mr Hussey moved forward and laid the petition on the Table.

Mr Speaker: I will forward the petition to the Minister of Agriculture and Rural Development and a copy to the Chairperson of the Committee for Agriculture and Rural Development.

Assembly: Committee of the Centre

Resolved:
That Mr Duncan Shipley Dalton shall replace Mr Fred Cobain as a member of the Committee of the Centre. — [Mr Davis.]

Assembly: Committee for Health, Social Services and Public Safety

Resolved:
That Mr Tom Hamilton shall replace Mr Alan McFarland as a member of the Committee for Health, Social Services and Public Safety. — [Mr Davis.]

Assembly: Committee of the Centre

Resolved:
That Mr Danny Kennedy shall replace Mr James Leslie as a member of the Committee of the Centre. — [Mr Davis.]

Primary Care

Dr Joe Hendron: I beg to move
That this Assembly expresses its grave concern about the future of primary care services in Northern Ireland and calls on the Minister of Health, Social Services and Public Safety to take prompt action to allay the serious concerns of the professionals and staff working in health and social services about the arrangements for local health and social care groups.
The debate is about the future of primary care services in Northern Ireland. The Prime Minister, Tony Blair, and successive Secretaries of State have told us that the Health Service should be primary care led — it should be led from the coalface: from the bottom up; not from the top down. The former direct rule Minister, John McFall, produced a document some time ago called ‘Fit for the Future — a New Approach.’ It was addressed to the New Northern Ireland Assembly, and it expressed a vision of health and personal social services as a single integrated service centred around primary care.
The needs of people were to come first, and the needs of organisations were to come second. The proposed new groups are to be committees of the health boards. I welcome the end of fundholding because of the inequities in the system. However, the four health boards have been around for years, carrying out the commissioning for non- fundholding practices, and they have not succeeded. We are moving backwards rather than forwards.
I unequivocally support the setting up of new primary care groups, with multidisciplinary teams working together. However, the guidelines should have been issued a year ago — certainly, at least 10 months ago. Our vision for primary care should be similar to that in England — empowering front-line staff to use their skills and knowledge to develop innovative services, with more say in how services are delivered, and empowering patients to become informed and active partners in their care.
We understand the massive financial constraints on the Minister and the Department of Health, Social Services and Public Safety and I am aware of the recent report by the Northern Ireland Confederation for Health and Social Services (NICON), which covers the four boards. One of the points that it made was that an extra £100 million per year is needed, in real terms, over the next 10 years to bring the service up to an acceptable level. I accept that there has been a legacy of underfunding over many years. However, a 7·2% increase for the health budget was announced in October 2000; £17 million was allocated in November 2000; £14·5 million was allocated in January; and a further £18·5 million was allocated in February. In total, the budget available for 2002-03 will be over one third — 37% — larger than the budget when the Minister took office. That is an increase of £687 million.
There are huge pressures on primary care professionals. I must refer to the waiting lists, which everyone is currently talking about. I accept that there have been 20 years of underfunding, and I appreciate the efforts that the Minister has already made. We have the problem of the cancellation of outpatient clinics. We have so-called bed blocking — I do not like that term, but we all know what it means. I am aware of the Minister’s framework for action on waiting lists announced in September 2001 and the boards’ comprehensive waiting list plans and quarterly monitoring reports. Indeed, I think that there are also bimonthly meetings. However, if there were one board instead of four it might be easier, and we might get more uniformity of services across the North.
On 20 February, the Minister announced the establishment of 15 new local health and social care groups, and I will quote from her press release at that time. Commenting on the high degree of consensus among stakeholders in establishing the new groups, the Minister said
"I hope this will point the way to a continuing focus on partnership, co-operation and shared objectives, which will be crucial for the new Groups to fulfil their full potential."
I accept that, but there was not consensus among stakeholders on the option that the Minister chose. In the same press release the Minister said
"The experience of the five Commissioning Pilot Groups has shown that GPs and other primary care professionals working together in groups have improved the provision and quality of local services."
I agree with that statement, and I would have thought that the new primary care groups would be based on such pilot groups. However, Dr Harold Jefferson, chairperson of the successful Lisburn commissioning pilot, said in a recent letter to all MLAs
"I am deeply distressed and disgusted at the present plans for the local health and social care groups. What is to be their function?"
Dr Jefferson goes on to make the point that although we are told that the groups are developing from the commissioning pilots, they bear scant resemblance to these organisations.
On 1 March, the director of primary care in the Department of Health, Social Services and Public Safety replied to Dr Jefferson. In his letter the director blames the Assembly, because it voted last year to delay the ending of GP fundholding. However, Mr Speaker, you and Members know that the purpose of the amendment was to facilitate, and ensure that the Department brought about, a seamless transition into new primary care structures. Over a year has passed, and we do not have any such transition. The director also said
"We have always believed that a timescale for setting up the new groups is achievable, provided that there is appropriate commitment, co-operation and goodwill from all concerned."
However, there is total commitment and goodwill from all the professionals in primary care.
The problem lies with the Department, which seems to have wasted almost a year. It is inexcusable that the guidelines for new primary care arrangements have not been introduced in the last nine or 10 months. I have heard explanations from the Department about finance and personnel. It can juggle the figures in whatever way it likes, but the fact is that at least 10 months have been wasted. The guidelines must have been ready a year ago, and I do not see why they were not announced long before they were.
Mrs Hilary Herron of the Royal College of Nursing (RCN) sent a submission to the Assembly’s Health Committee, expressing the disappointment of RCN members. The RCN referred to the amendment tabled a year ago and the fact that seamless transition is now impossible. The RCN also stated
"Frontline primary care nurses have not had an opportunity to voice their opinions regarding the guidance on the constitution, governance and accountability arrangements."
Front-line nurses who work at the heart of the community should be represented in the group.
In its letter of 19 February 2002, the Northern Ireland Board of the Royal College of Midwives made various points, one or two of which I will quote
"We were profoundly dismayed therefore to find that the midwifery profession is not even mentioned in the recent Guidance Circulars, there is no recognition of midwives as primary care professionals, there is no provision to have midwifery representation on the Management Boards of the proposed new Local Health and Social Care Groups."
The Royal College of Midwives also stated
"Although the Minister in her announcement of 12 October 2001 indicated that there had been ‘broad support’ for the preferred model proposed in ‘Building the Way Forward in Primary Care’, the Royal College of Midwives, in common with most other professional organisations in Northern Ireland, including the Royal College of Nursing and the British Medical Association, did not support the proposal to establish LHSCGs as committees of the existing Health and Social Services Boards, seeing this as adding another layer of bureaucracy to an already ‘top-heavy’ structure for health care provision".
Dr Brian Patterson of the General Practitioners Committee (Northern Ireland) of the British Medical Association Northern Ireland also wrote on 1 February 2002 and made many points. I will not repeat all that group’s concerns except for two, which I will quote:
"lack of detailed guidance across the board bearing in mind LHSCGs are due to go live in 8 weeks’ time"
and
"no details of timescale as to when LHSCGs will be empowered".
All Members will have seen that letter, so I will not quote anything more from it.
The Northern Ireland Multi-Disciplinary Primary Care Forum stated
"We see proposals that still have no clear vision or commitment. They create, in the words of one civil servant, a set of new bureaucratic quangos."
It goes on. The Northern Ireland Public Service Alliance (NIPSA) quoted two aspects of deep concern:
"fair protection for GP fundholding staff…";
and
"inadequate public consultations about the Department’s guidance on the composition and operation of the proposed Local Health and Social Care Groups."
In relation to the first point, I am aware of the redeployment centre in the Central Services Agency. I have had telephone discussions with the relevant person there. I hope it works out, but I have doubts about it.
The bodies that wrote in totally supported the new groups, as we all do. They do not, however, make any reference to delays. Correspondence was also received from Prof Salmon, Chairperson of the Northern Ireland Trust Nurses Association, from the Directors of Nursing in the boards and from the Association of Directors of Social Services, whom we met last week. There were also a couple of other groups. We all support the local health and social care groups, but it is a question of how the groups are set up and why the guidance was not given long ago.
The Minister appeared before the Health Committee on Wednesday 6 March to discuss the health budget and primary care. We were pleased that she did, and it took several hours to cover both subjects. At the meeting, reference was made to the Committee meeting on Wednesday 27February, when representatives of the Royal College of Nursing, the British Medical Association GPs’ Committee and the Royal College of Midwives attended. Those bodies requested a meeting with the Minister. Members will have a copy of a letter dated 19 February, signed by Dr Brian Patterson, Mrs Hilary Herron of the Royal College of Nursing and Mrs Breedagh Hughes of the Royal College of Midwives, in which they expressed extreme worries about the situation. Those three groups represent many front-line staff, and, therefore, the Health Committee advised them that they should seek a meeting with the Minister. At the Committee’s meeting last Wednesday, we were told that no such request had been received. I subsequently found out that a letter, signed by all three representatives, was handed in at Castle Buildings on Tuesday afternoon. I am not suggesting that the Minister knew about that, but the letter was handed in.
I strongly support the primary care groups. We will be in big trouble if we do not get primary care right, because it is the basis of the whole Health Service. Everyone concerned must be involved in meaningful dialogue.
I welcome the end of fundholding, and I sincerely want the new primary care groups to succeed. We have had a golden opportunity for change. Perhaps it is not too late. The people of Northern Ireland deserve the best; it is now up to the Minister and her Department to achieve that.

Mr Speaker: The time limit for this debate is two hours. As one might imagine, many Members wish to participate. Therefore, in order to facilitate as many Members as possible, I am imposing a limit of six minutes on all contributions, except those of the Minister and the mover of the motion.

Dr Ian Adamson: My background is in community child health, although I trained as a general practitioner. I am acutely aware that early diagnosis has become increasingly important, due to recent advances in drug therapy and the potential gains from the modification of risk factors. In most areas of medicine early diagnosis assists the GP, as it permits the formulation of a management plan, which obviates much of the later crisis intervention. Family practitioners remain the central core of the provision of support and co-ordination in medicine, which benefits both patients and carers.
I am not a member of the Committee for Health, Social Services and Public Safety, but I keep in close contact with my Colleagues on it. The Department’s consultation paper, ‘Building the Way Forward in Primary Care’, had many positive features that can be readily supported. The proposals were outlined in section 6 of the document, following an analysis of five models or options in the previous section. This is the model described as option 3, evolving into the option 4 model. Both models involve the creation of multidisciplinary care groups to serve populations of between 50,000 and 150,000. Option 3 proposes groups that would be mainly advisory, while option 4 proposes groups having devolved commissioning budgets.
If any approach is to be successful in developing the agenda for change in health and social care and developing the full potential of primary care, we must clarify the concept of primary care to include health, social and community care. It is inevitable, and highly desirable, that closer working relationships with community trusts will develop, and, eventually, integration can take place between the new local health and social care groups as equal partners.
Adequate resources will need to be prioritised to allow the new groups to flourish. Important areas include training and managing support and resources for infrastructure and programme development. The costs involved in information and communications technology (ICT) development are considerable, but essential if desirable quality improvements are to be realised.
Much will depend on the overall resource allocation to health and social care. If the allocation is inadequate, no amount of innovation or efficiency will be able to deliver the required outcome. Northern Ireland should aim to have at least the same resource per capita as any other region in the United Kingdom — preferably a sum that fully reflects the additional needs of our population.
Option 4 might not be an end in itself, but it is a firm foundation for further developments in integrated health and social care delivery. The Department has said that it must ensure that the right structures are in place and that the right policies are pursued in order to achieve the Executive’s strategic priority of working for a healthier population. However, we must not become bogged down in bureaucratic wrangling when the real war is against disease, social injustice and the inequalities in health and well-being for a large section of the population.

Mr Paul Berry: The motion does not argue for the retention of GP fundholding. Indeed, the argument is not about the merits or demerits of GP fundholding, which, as it is currently constituted, is dead in the water. Those who wish to rehash arguments over that issue have lost the plot, or at best they want to deflect attention away from the real issue that the motion is concerned with.
A recent newspaper report about the discontent over the circumstances surrounding the ending of GP fundholding exemplifies all that is wrong about the way in which the Health Service is run in Northern Ireland. It is one thing to remove GP fundholding, but it is quite another to turn back the clock by 10 years without any understanding of what will replace it, or without the implementation of a replacement that will fit in with the improvement of the Health Service. That is not only sheer incompetence but official ignorance under the guise of skill.
(Mr Deputy Speaker [Mr Wilson] in the Chair)
In its wisdom the Assembly gave the Minister and the Department a year to come up with clear plans that were properly resourced and carefully set out, and which could be supported fully by the Committee for Health, Social Services and Public Safety and the primary care sector. Instead, the Minister was aggrieved when the Assembly delayed the ending of GP fundholding for another year. That was a wise decision. There was no replacement on the table, under the table or outside the door. There were not even mirrors. It is now one year later and — surprise, surprise — the issue is not much further forward. It is little wonder that professionals are distraught and angry. The seamless transition is non-existent. The Minister has angered just about everyone who is involved in the delivery of services. Doctors, nurses, midwives and a host of other professionals are extremely angry at the latest botch-up by the Department.
What has been happening? Since the issue was last debated in January 2001, little has happened. In the past few weeks, however, there has been some activity. The Department issued a press statement on 16 October 2001. Impressively, it took from January 2001 to October 2001 to come up with that. The statement was followed by a circular on 14 December 2001. There was no consultation or negotiation before, during or after those events. It is an attempt at change by uninformed, incompetent diktat. It is clear that if the Minister had spoken to professionals, she would simply have exposed her own ignorance.
The Minister promised the Assembly that when GP fundholding was replaced, all would be well. All is not well, and worse still, there will now be a gaping hole where once was there were clinicians in operation. That is hardly the most brilliant piece of leadership. There is chaos, uncertainty and, at best, mere cant. It is unacceptable that just a few weeks before the changeover nothing concrete is in place. Perhaps everything is supposed to happen over the next couple of weeks, as if by magic. Furthermore, there is no blueprint. Neither the Health Committee nor the Assembly has been presented with the finalised blueprint for primary care, a blueprint that should have been debated and voted on by the Assembly. That would show professionals where things are going. How the Minister can continue to make piecemeal changes without a plan is beyond the comprehension of any rational individual.
The Minister, the Department and those who work in the primary care sector do not know where things are going. Not once has there been a simple outline of how the removal of GP fundholding, in the absence of any specific transitional scheme to finalised agreed arrangements, will improve either the quality or quantity of care. There has not been one piece of hard, factual data. The Assembly is entitled to hear how the removal of GP fundholding will improve the quality and quantity of care to patients in the absence of a transition to finalised arrangements. Where are the hard, real, factual data?
On 17 January 2001 it was recorded that the Chairperson of the Health Committee expressed the strong view of the Committee that GP fundholding should cease only when the Department could make the planned seamless transition to an agreed alternative.
Amazingly, we are no further on today. Those who argued against our motion last year said that it was wrong. One Member had the nerve to suggest that an extension would not allow for a proper replacement for GP fundholding to be put in place and that it ought to go immediately.
We must listen to the British Medical Association (BMA), which wrote to the Committee for Health, Social Services and Public Safety about the end of GP fundholding and said that there had been no detailed guidance, no details about timescales, no proper resources, no meaningful consultations, no primary care development funding and no details about the redeployment of GP fundholding staff. That is a clear vote of no confidence on the part of the professionals. I support the motion.

Mr John Kelly: Go raibh maith agat, a LeasCheann Comhairle. This motion does not come before the House with the full consent of the Health Committee. The vote was 4:3 in favour. My Colleague, Sue Ramsey, and I opposed its tabling because of the same misinformation that we have heard from Mr Berry. We believed that the motion would be divisive and would not be concerned with primary care or with the delivery of healthcare to those who need it.
At the Committee’s meeting last Wednesday, Sue Ramsey and I asked for the motion to be postponed for a week or a fortnight to allow people working in primary care piloting commissions to address the Committee. The Committee has only heard from groups opposed to the transition from GP fundholding to primary care. Even within those groups, there has been marked disagreement over the way forward.
I thought that the Committee’s function was to bring the Minister before it to address its concerns about primary care and to ask people working in that sector to give the Committee their views on the transition from GP fundholding to primary care. That did not happen. There was no consensual discussion from those representative bodies in favour of primary care. Their point of view was not heard. The only point of view that the Committee heard came from those who were ostensibly opposed to the introduction of primary care. The Royal College of Nursing, the Royal College of Midwives and the BMA disagreed among themselves over the way forward.
It was inappropriate for the Chairperson of the Committee, as a GP, to bring the motion to the House without declaring his interest in the transition from fundholding to primary care.

Dr Joe Hendron: On a point of order, Mr Deputy Speaker. If Mr John Kelly looks at the record of the debate last January he will see that I clearly and unequivocally stated my slight link with primary care at that time. My position has not changed since then.

Mr Robert McCartney: On a point of order, Mr Deputy Speaker. The Assembly is entitled to note that the Chairperson of the Health Committee, Dr Joe Hendron, is a GP — the world and his wife know that. Any suggestion in these circumstances that he has any axe to grind or that he has misled the Assembly or the Committee in any way is quite wrong, and that should be stated.

Mr John Kelly: The Chairperson’s vested interest in GP fundholding was not on the record of this debate.
The House of Commons Select Committee on Health said of the transition from GP fundholding that it would improve patient care and the health of the population by
"putting doctors and nurses into the driving seat and by ensuring co-operation rather than competition within the NHS".
We support that.
The Committee’s second report also recognised that
"there have been some problems with implementation in areas where there have, historically, been tensions between fundholders and non-fundholders and that changes are going ahead more smoothly in areas where general practice has traditionally enjoyed a good relationship with the health authority."
It went on to say that all health professionals in primary care, whether in general practice or community trusts, were finding the pace of change quite threatening, so there have been difficulties in England, Scotland and Wales with the transition from fundholding to primary care. Such expressions of doubt and concern have not just come from this Assembly, its Committee for Health, Social Services and Public Safety and its Health Service.
My colleague and I oppose this motion, because ample opportunity was not given to practitioners in primary care to express their views to the Health Committee. There are difficulties, but the best way to address them is for the Minister, the Committee and all the groups involved in the transition to meet and discuss how those difficulties could be solved. A more orderly method of teasing them out is by discussion and debate. There is no doubt that primary care is the care of the future — by all objective standards of critical analysis it can ease tensions in the Health Service. Go raibh maith agat.

Mr Kieran McCarthy: I thank Dr Joe Hendron, the Chairperson of the Committee for Health, Social Services and Public Safety, for bringing a vital subject to the Floor of the Assembly. I also welcome the Minister and hope that she can help us to overcome our concerns.
We must not forget that the one-year extension to GP fundholding brought benefits to local communities. However, we are a few weeks away from the introduction of an entirely new system, and I am deeply disappointed that very little is known about how things are expected to work out. I hope we are not experimenting with the health, and possibly the lives, of people. Ordinary people want and expect a good local GP service, and in general they are not interested in how it is administered.
All Assembly Members have received correspondence from anxious people, one organisation noting that
"A year of development time has been squandered, Assembly wishes ignored…."
This is not the first time that Assembly wishes have been ignored, and we must act to ensure that the will of the Assembly counts and is acted upon by the Executive and its Ministers. The same organisation concluded that
"the opportunity to change the HPSS to work better for the population has also been ignored.
We see proposals that still have no clear vision or commitment. They create a set of new bureaucratic quangos. They have no obvious purpose or goals, certainly none that could not be achieved by existing arrangements."
In addition, the Hayes Report identifies the need for a strong, well-organised primary care system. That does not seem to be the aim of current policy guidance, and it certainly will not be its outcome.
I support local primary care groups that can and must make a difference to the health of our constituents. I appeal to the Minister to heed the advice of medical professionals who have years of experience and are willing to see change succeed. There is no reason to change the system unless we are confident that it will bring early benefits to health provision for everyone. That must be a priority for all. I support the motion.

Ms Jane Morrice: Health and social care groups will improve prospects for better services if they are developed through meaningful engagement between professionals and service users. The experience drawn from successive primary care pilot schemes has shown that family doctors, community nurses, social workers and other professionals can work together successfully to redesign and develop services for the community. For the benefit of all, we must grasp and exploit the opportunity to extend this concept to people throughout Northern Ireland.
The purpose of local health and social care groups is to give the people who work in primary care, and the communities that they serve, more influence over the way in which services are arranged and developed. At present, planning and development of the services is organised through what is called "commissioning", and responsibility rests with the four boards. It is important that, under the new arrangements, the next few years will see local health and social care groups gradually taking on more responsibility for commissioning services. Most importantly, the process must be undertaken through effective, collective working between professional staff and community representatives. We hope that the boards will be fully committed to actively supporting the growth and development of these groups.
We have stressed on several occasions the importance of how the 18 members of each group will be chosen. When the groups become fully operational, five of the members will be GPs, and the remainder will be made up of a range of grass-roots health and social care professionals, including those allied to medicine, nursing, pharmacy and social work. It is significant that two members will be community representatives who will promote the interests of patients and other service users.
Scotland, England and Wales are already moving in this direction, and it is time for Northern Ireland to develop such community groups. A balance must be struck between representation and the obvious need to not make the groups cumbersome. Initially, not everyone will be able to achieve representation. We are glad that there is a mechanism to review the situation within 18months. Groups will be able to be flexible, but I stress that midwives should be represented on them — they must not be left out.

Ms Sue Ramsey: I understand the Member’s concern about midwives. The Royal College of Midwives expressed that concern, so I raised the matter with the Minister in the Health Committee meeting on Wednesday. The Minister said that, in the guidance, "nurses" is used as a generic term and does not exclude midwives.

Ms Jane Morrice: I thank the Member for that information. That is good news, and I hope that midwives will be included.
Real opportunities to improve services and build community confidence and the confidence of professional staff do not come often and must be quickly and properly grasped. It is clear from letters that we receive that there are concerns about the Health Service, but they can, and should, be addressed through the normal channels. My Colleague, Monica McWilliams, as a member of the Health Committee, will be working to allay those concerns.
Making changes to health and social services is rarely risk free. However, it is a hugely important task that is often wrongly perceived as presenting a threat to the stability of existing services and to the jobs of much- valued health and social care staff. Health and social care groups can strengthen services — they pose no threat to the roles and jobs of front-line staff. If anything, they maximise opportunities for staff and provide a basis for professionals from many backgrounds to interact more readily with patients and to tailor successfully services to meet their specific needs.
Although we accept that the Minister should work hard to allay existing concerns, we do not support the motion. This is a real chance to make meaningful and constructive change to primary care services in Northern Ireland, and we should take that chance when we can.

Mr Robert McCartney: I support the motion. It is public knowledge that the Health Service as administered in Northern Ireland is dysfunctional. The waiting lists are not only the worst in the United Kingdom, they are the worst in Europe, and it is plain that organisational reform of the delivery of primary healthcare is nothing short of chaotic. What are the reasons for that? The first reason is how resources are used, and the second is the delay in this much-needed reform.
As Dr Hendron rightly pointed out, capital investment in the basic infrastructure of health was underemployed for many years under direct rule. However, that merely underlines the failure of those who agreed the terms of devolved Government to ensure that the underspend on capital infrastructure funding was made good.
Having said that, resources are also being massively reduced by a welter of bureaucratic expense under devolved Government. Several weeks ago, I pointed out that £1·2 billion will be spent on the administrative costs of running the 11 Departments and the Assembly. Almost 14% of the block grant is being spent on feeding the Assembly and its administrative processes, which are a dripping roast for those who benefit from them.
I have been recently informed that the cost of ministerial cars, which are provided by the Assembly and by the Administration, amounts to £1·2 million per annum. Something must be done about resources. We shall not receive more resources through any increase in the Barnett formula, so they must be obtained in other ways — and not by petty efforts such as raising the rates by £12 million to screw many small businesses and put them out of business when that £12million will cover only one third of the £36 million needed to meet the Office of the First Minister and Deputy First Minister’s administrative costs alone, Mr Trimble’s Department. Therefore, something must be done about resources.
There is also the issue of organisational reform. It is plain from correspondence to Members from the professional organisations affected by these reforms — GPs, midwives, nurses and other care professionals — that the transitional arrangements for going from fundholding to the provision of primary healthcare through local health and social care groups is nothing short of a disaster. The Minister has provided no guidance on the core issues. Local groups cannot influence either the commissioning of secondary care services or primary care development, and we have no details of the timescale within which the groups will be able to do that other than a bare statement in a circular.
The Minister’s statement of 16 October 2001 about groups progressing to delegated budgets as quickly as they can demonstrate their capacity to deal with them entirely ignored the fact that a broad spectrum of fundholders and other groups have experience of controlling their budgets and could do that efficiently. There are no guarantees with regard to service provision to patients after 1 April. However, the Minister has done something about that belatedly. The funding arrangements are totally inadequate. In Northern Ireland the funding will be £3 per patient; on the mainland the funding is between £7 and £8 per patient. How can any form of comparable primary healthcare service be delivered when the cost of providing that is being cut from £7 or £8 to £3? There is also a lack of meaningful involvement of all stakeholders in the process, and there has been no meaningful consultation on the constitution of the groups, the management boards or the remuneration arrangements.
In response to John Kelly, I will close by stating that most groups are totally opposed to what is happening. The South and East Belfast Primary Care Group had this to say:
"In February 2001, the Assembly rejected the timetable then proposed to develop new Primary Care structures issued by the DHSSPS. The Assembly accepted the argument that the gap between the ending of existing arrangements on 1 April 2001 and the earliest operational date of any new proposals would be detrimental to the provision of Primary Care services."
The Minister and her Department have wasted an entire year and have failed to put in position any guidance, instruction or constitutional arrangements whereby primary care can be developed. I have great pleasure in supporting the motion.

Mr Eddie McGrady: I approach the motion and its expression of concern for the new structural arrangements based on information that I have received from people on the streets and in constituency offices, including people from the medical fraternity, and their experiences. There is enormous and grave concern that the new structure is not even designed to deliver better primary care and will constitute yet another bureaucratic structure laid over an already overstructured delivery of medical facilities.
There is concern about the levels of bureaucracy and the levels of resources that were supposed to be available for the new development. I hoped, as did all laypersons, that the new structure would speed up access to primary care and contribute to shortening the much-quoted waiting lists, which are causing increasing daily concern to people on both elective and non-elective waiting lists. An increase over the past year of 14·5 % and a failure by the Department to achieve its set targets and explain why those targets are not being met against a backcloth of increasing funding are shortcomings, not least in clarity.
We must try to achieve that clarity so that we can redress what appears to be happening, which seems to be — and I cannot substantiate this with facts and figures — more money chasing less effective delivery. If that is the case, it requires an urgent and extreme remedy.
I come to the debate not from the point of view of statistics or finance but from my experience and knowledge of the unnecessary pain and suffering being placed on families, the communities and the country. The relief of pain and suffering is the objective of all medical services.

Mr John Kelly: Will the Member give way?

Mr Eddie McGrady: No, I have just started. I will give way when I come to something substantial that the Member might wish to query, but I have not dealt with the generics yet.
It is correct to look at how efficiently and effectively the Heath Service is administered, but that must be done with the objective of achieving better relief of pain and suffering. We cannot include in a motion such as this the provision of care for cancer patients, because that is not primary care — although initially everything is primary care. People are literally dying against a backcloth of a lack of medicines and treatments that are available elsewhere, and that is never acceptable in a society such as ours.
Alongside that, medical professionals — GPs, midwives and district nurses — do not know how the proposal can work, and they do not know why it has been made. In fact, GPs have asked the Department to explain the objective, purpose and facilities that will drive the new structure, which will start in two weeks, but they have not had a meaningful answer.
We have heard Members talking about a variety of bodies — the Royal College of Nurses and the Royal College of Midwives — who say that there has been no meaningful consultation on their participation. However, district nurses and midwives are primary carers. If they do not know what is going on, what, in the name of God, are the patients going to do?
GPs are not sure about what is happening and what will be expected from them. The new body to be set up — and I stand to be corrected on this — will consist of GPs, who will get an extra £17,000 a year for administration. All of the others, midwives, district nurses and lay people, if there are any, will get nothing. This is not an even-handed scheme that will encourage co-operation and a better development of resources.
The BMA finds the process incredible. It says that there is no long-term vision, no medium-term plan and no short-term direction. It criticises the lack of information it is receiving from the Department, information that is necessary to achieve what, it is hoped, will be an improved system of delivery.

Mr Jim Wilson: Time is up.

Mr Eddie McGrady: My goodness — time passes when you are enjoying yourself.

Dr Esmond Birnie: In case Mr John Kelly should ask, I am not a medical doctor, so that should be all right. I thank Dr Hendron for giving us a timely opportunity to speak on the subject.
I want to focus on the local health and social care groups, because they are very much at the nub of the motion. As several Members have said, it is significant that many care professionals have expressed doubts about the proposed arrangements, notwithstanding the general support for the broad principles of primary care groups as set out in ‘Fit for the Future’.
Unfortunately, the current proposals from the Minister and the Department are inadequate to empower and resource, as Mr McGrady mentioned. For example, where, in the current proposals, is there clear, detailed guidance on the formation and function of local health and social care groups? Crucially, why is there is no meaningful involvement in commissioning from the outset? If that does not occur — and some of us doubt whether it will ever occur in the future — social care groups will simply become another talking shop in a sector that has too many layers of administration.
A more malign interpretation of what may be going on is that to the extent that the groups will include membership from the health boards, this change is, in effect, a way of entrenching the power and position of the health boards. That is something that should be subject to review, and I hope that it will be subject to investigation during the overall review of public administration. Furthermore, there seems to have been a complete lack of involvement of many of the grass-roots stakeholders, especially community nurses and professions allied to medicine.
Our primary health care system differs substantially from, for example, that in America and much of the rest of the EU. Many commentators have judged that features of our primary system, especially the way in which GPs and others act as gatekeepers to care elsewhere in the system, are good features that should be cherished and developed. The problem with the Minister’s proposals is that instead of carefully prepared evolutionary change, we seem to have in the offing, from the beginning of next month, something that is, in effect, a diktat. Diktats may well be attractive when coming out of a revolutionary approach to politics, but, in general, they are not a sensible way in which to engage with the major stakeholders, civil society, and to make sensible, evidence-based approaches to policy. I have great pleasure in supporting the motion.

Mr Jim Shannon: I support the motion. There are many people with cancer in my constituency, which has a predominantly elderly population. The GP surgeries are so packed that we must plan to be sick at least two weeks in advance. If, God forbid, we plan to injure ourselves, we must give one week’s notice to the treatment room for an appointment with the practice nurse. Those are facts.
It is unbelievable that someone who has severe pain because of a genetic disorder cannot get relief from pain that has been debilitating him for at least three days, because that is the earliest that he can get an emergency appointment. Such patients know that they are not ill enough to attend casualty. Many also do not feel that they are ill enough to sit for four to 12 hours in a busy emergency department when all they need is a prescription for pain relief that could be easily taken care of with a ten-minute chat to their GP, who is familiar with their condition.
The NHS plan states that, by 2004, the Government will have revolutionised their primary care services. By 2004, many people will have encountered much pain and discomfort. Many will have resorted to incurring large bills for private treatment, so that at least they can see someone when they are ill and not two weeks after the event.
We have all heard of the baby twin across the water who died after NHS helpline staff told her parents that she had colic and how to treat her. The baby had meningitis and died in days. Believe it or not, the Government plan to use the helpline and an Internet site even more to reduce the number of people using the doctors’ surgeries and the numbers in the waiting rooms of doctors’ surgeries and hospitals. Is that just another way of fudging the figures? Many believe that that is a possibility. As elections approach, the need to reduce waiting times will help people to focus more.
Primary care, like every other part of the public sector, was underfunded by the Government for 20 years. The Conservative Government put the primary Health Service under self-management, and, to some extent, that worked. However, the population keeps growing, and the funding has stayed low.
Some GPs have found a better way of managing the money and do not want the new reforms, as they are now presented, to come into effect. They are just beginning to pull together under the strain that the last reforms caused. A surgery in Strangford took a long and incisive look at the patients that attend there. They found that they fell into two categories — the asthmatics and the elderly. The doctors put a major part of their budget into those two problems and set up a clinic for asthmatics to free some of the time that they spend with their patients. Patients with asthma now have an allotted time for seeing their doctor and the main nurses.
The doctors also set up an elderly patients’ well-being clinic to deal with flu vaccines and other forms of preventative care to free space during the day for other patients. By giving those two groups weekly clinics, the doctors have seen great improvements in other areas of their practice. They have been able to see more of other patients, and they do not have these problems in greater number than before. Asthma is an increasingly common condition in modern society.
Those doctors, and many like them across the Province, took the initiative and made fundholding work for them. However, as usual the Government, instead of investing the money where it is needed, will restructure and shove this bit and remove that bit, and, lo and behold, we will have a new and improved "primary care service".
Doctors in my constituency have contacted me with complaints about the restructuring of the primary care sector of the Health Service. GPs have been told that this new scheme will be the answer to their prayers. Doctors disagree strongly. They believe that there has been no long-term vision, no medium-term plan and no short-term direction for putting the new scheme in place. Doctors have said that neither the Minister nor anyone from the Department can tell them, except in vague terms, what the strategy is. They fear that patient- focused primary care-led services are being replaced with cost-effective primary care.
The Health Service should not be about money. However, for certain conditions, a week’s drug treatment can cost up to £1,000. Does the strategy take into account the time and energy that doctors need to face the problems caused by the inadequate system that is proposed for April? Doctors fear that because of the stress and strain of implementing another of the Department’s schemes for cutting corners and money, they will lose colleagues with many years of experience under their white coats.
Doctors have finally got to grips with the fundholding strategy. Many have used it to further their practices by getting more nurses and other services such as physiotherapists, opticians, dentists and counsellors to join their units and form one-stop clinics for all their family needs. Other surgeries in my constituency have looked at other areas of the profession, such as patients with heart complaints and ECG monitors. These doctors do not think that the system is broken, and wonder why the Department is trying to fix it, and fix it in a way that will leave those who are trying to work in the new system, with only weeks to go before it is enforced on them, with only vague notions of what will happen?
Doctors whom I have talked to say that we should look at the system in England, and I agree. With my concerns and those of my constituents in mind, I call for answers to be given.

Ms Sue Ramsey: Go raibh maith agat, a LeasCheann Comhairle. It is right that Mr John Kelly should call on the Chairperson of the Committee for Health, Social Services and Public Safety, Dr Hendron, to declare an interest. That is part of the procedure in the House. He was not implying that Dr Hendron did not do that deliberately. He was saying that it was right that it should be declared.
Members have said that there are concerns among the professionals about the new arrangements for primary care. I also have concerns, and after Mr John Kelly and I met the professionals last week, I agreed to raise those concerns with the Department and the Minister. Many of us are not experts on what is happening. Several Members have admitted that, without going into detail on the establishment of the new arrangements because they are not members of the Committee.
We met with people who were in favour of the new arrangements and also with people who were opposed to them. Contrary to what many are saying, there are people who are happy with the new arrangements. The Committee should have allowed those groups to give their views. When changes are in the air, hard decisions must be made. People are concerned about taking that leap of faith. They have relevant concerns, and we should take them through those changes step by step.
The Minister gave evidence to the Committee for Health, Social Services and Public Safety on Wednesday 6 March, when she gave a presentation and answered questions. In the limited time that I have, I wish to place her answers on the record. The Minister said that the objective of the new groups is to reduce bureaucracy, promote inclusivity among primary care professionals and move resources into front-line services. She told the Committee that the groups’ aim is for local people and local health professionals, using their expertise and knowledge of what is needed, to come together to ensure that those needs are met. I do not believe that anyone could oppose that.
(Mr Speaker in the Chair)
Several Members spoke about the £3 per head for administration costs and the fact that in England and Wales it is £7 or £8 per head. I could not stand here and justify any more money being spent on administration. We have all spoken about the levels of administration in the Health Service. My conscience would not allow me to argue for more spending on administration and less on front-line patient care.
The Minister answered several questions on issues that have been raised in today’s debate, such as the make-up of the primary care management boards. The Minister told the Committee that she was confident that the configuration of those boards was such that no single group would be dominant and that representation would be well balanced. I agree with that, because there should be no single dominant force. If we are to tackle collectively the needs of our communities, many people should be involved.
Ms Morrice mentioned the inclusion of midwives in the guidance. That was put to the Minister, who told the Committee that two posts would be available for nurses and that the use of the generic term "nurse" did not exclude midwives and health visitors.
Concerns were raised that some nurse-led services would be lost under the new arrangements. The Minister gave an assurance that all health care provided under GP fundholding would be maintained. The Royal College of Nursing also raised that. The Committee met with that organisation on 27 February, and I asked its representative to give me an outline of the services that it thought would be lost. To date, I have not received that information. We must approach this in a mature fashion. Many groups favour the establishment of the new primary care arrangements, and we must give them the benefit of our attention.
There are concerns that another level of bureaucracy is being created that will result in yet another talking shop. We were told in the debate on the Executive’s review of public administration, which, in my view, should have started a long time ago, that the Department is confident that the new groups are flexible enough to be accommodated in any wider structural change. Were we being told to delay or that GP fundholding should not be changed until the outcome of the review while, in the same debate, we were told that we need to tackle the level of bureaucracy in the Health Service?
Several issues must be taken on board. GPs are an essential part of the new plans. However, up until now, they have not been a part of the Health Service in contractual, financial or employment terms. I commend GPs because they are doing tremendous work. However, they must be part of the group. They cannot drive the group, and they should not have the automatic right to chair the group. We can all tackle the need for services and promote health in our communities.
I commend the Minister and the Department for ensuring that community representatives and service users will be involved in the new groups. Go raibh maith agat.

Mr Tom Hamilton: I support the motion. A year ago the Minister was intent on ending GP fundholding, with no system available to replace it. At that time, the Committee for Health, Social Services and Public Safety rightly refused to back what the Minister wanted to do in the timescale in which she wanted to do it. That delayed the ending of GP fundholding for one year. The intention of the delay was to give the Minister time to take into account the findings of the primary care review and the Hayes Report and to create what has been referred to as a "seamless robe of medical care". Sadly, the Minister has squandered the opportunity given to her by the Committee and the Assembly.
In the intervening year, she has managed to annoy virtually the whole spectrum of primary care professionals, including GPs, nurses, midwives and community care staff, not to mention the Health Committee. One has only to read the minutes of evidence given to the Committee by the groups that I have mentioned to gauge the level of annoyance that has been caused. I do not understand why the situation had to arise. If every other Minister and Department in the Assembly can work closely with their Committees, why is it that relationships between the Health Department, its medical staff and its Committee are in such disarray over this?

Mr John Kelly: Will the Member give way?

Mr Tom Hamilton: No, I will not give way.
The Committee recently took evidence from those professionals, and the view is that the Minister has made minimum primary care proposals. She has missed a golden opportunity boldly to introduce what was envisaged in ‘Fit for the Future’. That system would have seen a patient-led Health Service with money for services allocated to the primary care groups and professionals close to the ground, who could decide on the most appropriate forms of medical care. That, however, has not happened, and we are faced with the creation of yet another level of expensive bureaucracy that will take money away from what it should be used for primarily — investment in patient care.
Many Members are fully aware of the overadministration of medical services in Northern Ireland. The Minister needs to make immediate plans to stand down those organisations in order to bring about the devolution of medical funding to primary care groups.

Mrs Iris Robinson: Detailed guidance on the constitution, governance and accountability arrangements for local health and social care groups, and the remuneration arrangements for those groups, was issued only on 12 February 2002 for implementation by the boards by 1 April 2002.
That leaves an unrealistic six-week timeframe. Having had 12 months to do all this, the Minister has left only six weeks for those involved to establish the local health and social care groups. What a waste of a year. In the words of the Northern Ireland Multi-Disciplinary Forum
"A year of development time has been squandered, Assembly wishes ignored and, more importantly, the opportunity to change the health and personal social services to work better for the population has also been ignored."
The Minister announced on 12 October 2001 that there was broad support for the preferred model proposed in the document entitled ‘Building the Way Forward in Primary Care’. However, the facts speak differently. The Royal College of Midwives, the Royal College of Nursing, and the British Medical Association, in common with most other professional health organisations here, did not support the proposal to establish local health and social care groups as committees of the existing boards. They saw that as adding another layer of bureaucracy to an already top-heavy structure for health care provision. That has not been helped by the failure of real dialogue between the Minister and primary care professionals.
Many GPs believe that the arrangements the Minister intends to pursue will not enable primary care professionals to improve the quality or quantity of care for patients. GPs believe that fundholding was not perfect; however, nothing is. They rightly claim that we should build on the developments of the past and on recent innovations and start to protect services that have already been introduced. Their concerns — and they are genuine — are that no direction and no real additional moneys have been identified and that there is no capacity within primary care to increase services so as to reduce referrals to hospital and facilitate earlier discharge. In my meetings with GP representatives, they have often quoted the Hayes Report’s call for primary care services to be provided more locally, so that a high-quality service can interrelate with hospitals and lead to a higher rate of successful outcomes for patients. General practitioners believe that that will not happen under the proposed system; indeed, they believe that it represents a retrograde step.
There is concern at the lack of clarity on the function of the local health and social care groups. The transition from the end of fundholding to local health and social care groups is only weeks away, yet the guidance issued to date focuses only on the establishment of the groups and is vague about their purpose and strategic direction. Many argue strongly that these groups represent another level of costly bureaucracy choked with red tape.
Boards will constitute the committees and from April 2002 will arrange the delegation of functions to local health and social care groups. Boards will be responsible for setting up the management boards of the local health and social care groups and for ensuring that they fulfil their primary care development. In collaboration with health and social services, the boards will develop the capacity to take on responsibility for commissioning hospital and community services.
The make-up of the local health and social care groups is also a matter for concern. Where GPs and other health care professionals have had some experience in primary care commissioning, it will be a completely new exercise for many others. Why did the Minister not use the last year productively? Why were no training exercises commissioned to enable primary care professionals to participate properly in the new groups? Who will make them up? Will they be based on the bottom-up philosophy, or will they be top heavy? It is proposed that GPs will have between three and five seats on each local health and social care group management board, depending on the size of population to be covered. Potentially, these boards will include up to six community trust representatives, one acute trust representative and up to two health and social services board representatives. At least three of the community trust representatives will be from director level, making a mockery of the bottom-up approach envisaged.
Many other valid concerns have been raised by representatives of all the professions involved in primary care. For instance, why have midwives been excluded or ignored as an independent profession involved in primary care? They have failed to become eligible for seats on the health and social care group boards.
What is to happen to the employees of GP fundholders and Eastern Multifund, whose contracts expire when the new arrangements come into effect? The Minister gave public assurances in the Chamber that she would be sympathetic to the needs of those people. At the time she claimed that to lose these highly skilled people and their experience would be terrible.

Mr Oliver Gibson: I support the motion because there were many features of great merit in the proposal. At the consultation in Omagh, local care groups were considered to be a good idea. Difficulties arose about what that excellent phrase "good primary care" meant. The consultation process showed that all GPs there seemed to have different levels of aspiration. Although they welcomed the principle and the idea, they wondered how it would translate into practice.
In my area the Dunnamanagh practice caters for a large rural area that includes Ballymagorry, Bready, Magheramason and the rural hinterland attached to that that joins with Plumbridge and moves into Foyle. The Irvinestown practice covers a great part of mid-Tyrone and is joined with County Fermanagh. The Castlederg, Strabane, Newtownstewart, Omagh, Drumquin, Dromore and Carrickmore practices have local health pathways. Joining up the whole conglomeration will not lead to concentric health pathways. It was pointed out that operating large geographical areas as one local health unit, such as in west Tyrone, will create difficulties.
The consumer aspect was also raised. Every consumer has a high regard for his GP practice, which is the first port of call for him and his family. Consumers want to protect their practices and be sure that they will not be financially decapitated by another layer of local administration, which would include a chairman, a chief executive and 18 staff who will have to be paid attendance fees for their work. The funding for that is to come from the local practice area money. People view that as another barrier between them and the provision of care by the boards. They deem that costly administration as a great enough hindrance.
I speak for an area where there is less-favoured provision to meet health requirements and which scores high on the scale of health needs, in every possible way. The idea was welcome, but the last thing consumers want is another quango between them and the delivery of services. They do not want any further curbs or restrictions, financial or otherwise, between them and the health care provision they need.
To tell someone what to do, or to impose a solution, is not what is meant by consultation. The decapitation of the financial provision is not helpful. Therefore, the lack of guidance, and the BMA’s and other health professionals’ rejection of the plan, has left a potentially good idea in a quagmire.
I ask the Minister to re-examine the first idea for a seamless transition from the present system to one that is perceived to be good for local healthcare, but which appears to have no method of delivery. She must think again and allow time for change and for consideration of the guidance. We should learn from the mistakes that were made across the water, rather than repeat them.
In supporting the motion, I ask the Minister to give the medical practitioners the time and direction that they need to make a good job of what has always been a great primary care service in their localities.

Ms Pauline Armitage: Anything useful that can be said has been said, so, as usual, I shall take a slightly different line. I support the motion. No one can take issue with it. The motion expresses the grave concerns that the community, the Health Committee and the medical profession have.
I am slightly disappointed that several Members feel that they cannot support the motion. The Health Committee works extremely well under the fair and understanding attitude of its Chairperson, Dr Joe Hendron, and Deputy Chairperson, Mr Tommy Gallagher. The Minister is present for the debate, so I assume that she has concerns also.

Ms Sue Ramsey: To whom did the Member refer, when she said that some Members do not support the motion?

Ms Pauline Armitage: We shall know that when the vote takes place. I am not here to name people.
Surely there is no better way to deal with concerns than to deal with them immediately, not in six or seven months’ time. I do not want the issue to be fudged; enough issues have been fudged already. However, we all agree that GP fundholding will end and that we must replace it with another system.
The objective of establishing the new groups is to reduce bureaucracy and promote inclusiveness among primary care professionals. I want the Minister to state, if she can, how much money will be saved when we move from GP fundholding to local health and social care groups. Some time ago, I asked the Minister how much money would be saved if we were to cut the number of health boards and trusts. The Minister said that we would save a moderate sum. However, I was not sure what the Minister meant by "moderate", because the word means different things to different people. Therefore I asked for an exact figure, but I am still waiting. I live in hope, as always, that she will provide that figure. If we were to have fewer boards and trusts, perhaps more finance would be available for the Health Service. The Minister should have examined all moneys that are spent directly on healthcare.
Finally, the new health and care groups may have to change. Pharmacists feel that having only one pharmacist on a board is not enough. It is inadequate and unequal. However, I assume that the membership is not written in stone. I hope that the Minister will agree that if money can be saved on bureaucracy, it should go towards healthcare, which is more important than trusts and boards spending money on, dare I say, luxuries that the Health Service could do with.

Mr Tommy Gallagher: Foremost in Members’ minds today must be the fears and concerns referred to in the motion. I acknowledge the ever-demanding workload of primary healthcare professionals — GPs, nurses, physiotherapists, midwives, and many others. They are faced with that workload at a time when resources are scarce and the public’s expectations are increasing.
Members must also recognise that in the past resources for primary care have not been allocated fairly. There have been variations, inconsistencies and inequalities in the delivery of primary healthcare — for example, response times for out-of-hour services are much longer in rural areas than in the towns and cities. Members must also bear in mind the wider picture — how the Health Service measures up to the rest of Europe. There is no doubt that Northern Ireland lags behind. In many other countries the quality of service is well ahead of the primary care currently being delivered here.
Local primary care teams have been set up in many countries in Europe and in the USA. Doctors, nurses and other professionals come together with community representatives and a wide range of other interested parties in order to deliver the service. Those primary care schemes have shown that when they are given responsibility for budgets, they are able to target resources at those who are most in need in their local areas. The new local health and social care groups that are being set up on 1 April 2002 can do the same in Northern Ireland.
However, that potential will only be realised if the Minister, the Department, the Health Committee and the Assembly ensure that the right foundation is there to tackle inequalities and deliver better standards of care to local people, regardless of where they live. If the Assembly gets primary care right, it will considerably ease the pressures that acute hospitals are presently experiencing.
That must include taking on board the valid concerns of health professionals and the general public. Accountability under the new arrangements is a major concern. The new groups will be subcommittees of the health boards. No elected representatives sit on the health boards. Members must understand, therefore, why people are concerned. Final decisions on primary care should not be left to the boards alone. There needs to be a Northern Ireland-wide steering committee involving those groups to manage the change and to build confidence in the new arrangements. Primary care needs a detailed and clear- cut timetable of what will be commissioned, by whom and when.
Local groups that will serve border areas must be able to work in a cross-border context if they are to properly address the needs of the local people. All aspects of primary care should be handled in the most open and transparent way.
There are other concerns, not least the deep anxieties about possible job losses or about the downgrading of jobs for those employed in an administrative capacity under the current GP arrangements. I acknowledge that the Minister has made some attempts to address those concerns, but more work must be done. The Royal College of Nursing, for example, does not believe that the new arrangements will support the principles in ‘Building the Way Forward in Primary Care’. Those principles are designed to reduce bureaucracy, improve the delivery of the service and encourage grass-roots input into local health and social care.
There has been, as Members have said, insufficient time to digest all the new guidance that has been issued in the past few weeks. Training is a crucial issue if the capacity of the new local health and social care groups is to be maximised. We need an assurance that local primary care initiatives will continue and develop. I want the Minister to give a commitment that no services that currently operate under GP fundholding will be lost.

Ms Bairbre de Brún: Go raibh maith agat, a Cheann Comhairle. Beidh dhá fheidhm shainiúla ag na grúpaí áitiúla sláinte agus cúraim shóisialta. Ar an chéad dul síos, beidh siad freagrach as pleanáil agus soláthar cúraim phríomhúil, ach sa deireadh thiar glacfaidh siad le freagracht bhreise maidir le seirbhísí cúraim thánaistigh a choimisiniú. Sin gealltanas a thug mé; seo iad na feidhmeanna a bheidh ag na grúpaí.
Local health and social care groups will have two distinct functions. They will be responsible for planning and delivering primary care in the first instance, but they will ultimately take on the added responsibility of commissioning secondary care services. I have given that undertaking, and I shall outline the groups’ functions.
Local health and social care groups will be statutory committees — not subcommittees — of health and social services boards. They will have clear lines of accountability to boards for their actions. That will be especially important when groups assume responsibility for the substantial public funds that they will manage when they take on commissioning functions.
For an organisation of that nature to deliver on such a formidable agenda, it is essential that all health and personal social services sectors be represented, including people from trusts who will be able to deliver on the plans agreed by the group. It is essential that all those who were involved in the planning and delivery of services work together from the beginning.
Local health and social care groups are more inclusive than any other model in England, Scotland or Wales. Primary care professionals and services users will co-operate for the benefit of service users in their area. The involvement of primary care professionals and others in identifying local health and social care needs, and in deciding how those will be addressed, is an essential element of the commissioning process and is critical to the new groups’ success. The management boards of the new groups will be responsible for devising effective mechanisms to ensure the involvement of other stakeholders and members of the wider group who are involved at grass-roots level. That will ensure a bottom-up and inclusive approach.
It is important to recognise that the Assembly’s decision to delay the end of GP fundholding for a further 12 months tied up resources that could otherwise have been devoted to developing the new arrangements. The actual implementation process has not suffered any delay. When GP fundholding was extended last year, I agreed, when I was asked, to extend the consultation period on ‘Building the Way Forward in Primary Care’. As I told the Assembly at the time, it was our intention to establish the new groups up to September 2001 as resources became freed up as a result of an end to GP fundholding.
It was always the Department’s intention that the resources released from fundholding would be used to meet the cost of the new arrangements. The extension of GP fundholding meant that finance, people and resources could not be made available immediately to work on the arrangements for setting up new groups. Managing and monitoring the scheme in its final difficult year has absorbed resources which otherwise would have been devoted to the development of the new groups. Nonetheless, guidance on the new arrangements was developed simultaneously, and many complex issues were resolved.
As the guidance was developed, it was also necessary to take soundings from the various stakeholders. Excellent progress has been made on the basis of the guidance issued so far. The groups’ configurations have been determined, and management boards are being established. It will take time for the groups to become established properly, and they will develop at different paces. Commissioning will be a completely new experience for many of those involved in the groups. Moreover, it will take time for groups to learn to work together and to build up the experience and skills necessary to carry out effective commissioning. It is difficult to predict precisely how long it will take for all of them to be able to take responsibility for budgets for commissioning services. However, I have set a firm target for some groups to take on the commissioning of some services from April 2003.
From the outset, budgets for prescribing management costs and primary care development will be delegated to the groups, and they will begin to establish their infrastructure and to formulate their plans for the commissioning and delivery of health and social services. They will be expected to identify local health and social care needs and to draw up plans to meet gaps in services. They will use their primary care development money to commission local primary and community care services as appropriate. Next year I intend to deploy additional resources towards primary care development.
The groups must decide on local priorities, taking account of resource constraints and other factors. They will also contribute to their individual health and social services board’s commissioning decisions, which will seek to reflect local dimensions.
One objective of the new arrangements is to reduce bureaucracy. Another objective is to move resources into front-line patient care. The new arrangements reduce the number of commissioning bodies from 150 — the number of existing GP funds, plus pilots — to 15. The ending of fundholding means that there will no longer be short-term or individual case contracts. That too will reduce bureaucracy.
By holding the administrative costs of the new groups to an average of £3 per head, £2·5 million can be diverted ultimately from administration to primary care front-line services. The level of management funding here is the same as level one funding in England. Those groups were at that level when they were first established. With regard to wider structures and what might emerge from the review of public administration, the financial impact will be examined as part of that review. The Executive have agreed that that examination is necessary.
The composition of the management boards of the new groups allows for representation of key interests, without its being too unwieldy. A Member raised that point earlier today. That does not mean that any profession that is not represented on the boards, or that has less representation than desired, will not be able to contribute fully to the work of the group. The facility to co-opt others onto the management board, and the opportunities for participation at subgroup level, should provide for the appropriate involvement of all professions and interests.
Many Members have mentioned the preservation of services. I give an absolute assurance that all services provided by GP fundholders will be maintained until the new groups can decide on their future. I expect those professionals who currently provide those services to continue to do so. Most administrative GP fundholding staff will be redeployed in the service or will remain in their GP practice but engaged in other work. Initially, there will be 30 job opportunities in the new groups. The advertisement clearly states that midwives who work in the community will be eligible to apply for posts.
Boards have expressed their support for the new arrangements, and they will be held to account for their role in the development of the new groups. I will shortly discuss the general managerial structure.
Those nurses, midwives, health visitors, social workers, professions allied to medicine (PAM) staff, pharmacists and community users or representatives who self-nominate will be paid for their work on these groups. Only those who are nominated by boards and trusts will not be paid, as it would be considered part of their ongoing work. Staff on pilot schemes will remain in place until they have had an opportunity to apply for posts in the new organisations.
Fears were expressed that certain interests might dominate the group management boards. Those fears are not borne out by the commissioning pilots, which also have board and trust staff on their management boards. Board and trust representatives will fill six of the 18 places on the new management boards, and GPs will fill five places. Therefore no single group or profession will dominate the new groups. Also, as part of their quota, boards and trusts must nominate a nurse, a social worker and a PAM representative. That means that there will be two nurses, two social workers and two PAM staff on each group. The generic term "nurses" refers to nurses, midwives and health visitors whose names are on the register of the UK Central Council for Nursing, Midwifery and Health Visiting (UKCC). The management boards of the groups must then devise effective mechanisms to ensure the involvement of other stakeholders and members of the wider local health and social care group who are involved at grass-roots level. It will be up to the management boards of the groups to ensure that there is a bottom-up approach.
As regards the figure of £3 per head of the population for the new groups, the funding here is comparable to the funding of new groups elsewhere when they were being set up and before they took on greater levels of responsibility. I believe that this figure will be adequate for the initial stages of the groups’ development, but it will be kept under review. Maintaining administrative costs at £3 per head will also enable me to divert £2·5 million to primary care services. That money will be shared with the groups, which will decide how it will be spent. It is important to note that the figure of £3 per head of the population, which amounts to over £5 million, simply meets administration costs. It will be spent on allowances for management board members, support staff and on supporting any additional infrastructure that the local health and social care groups decide to establish. It may also be used for some internal training and development. I will make additional resources available for the purpose of providing or developing primary care services.
From April 2003, local health and social care groups will be able to commission a wide range of health and social services and to draw down from boards the necessary resources. The commissioning role of the groups will grow over the years as the groups gain experience and confidence. I cannot foresee the end point now, because health and social services structures may change following the reviews of acute hospital services and public administration. Both reviews address the wider question of structures. However, I am sure that the groups will play a growing role in the planning and delivery of services and, to look at it in another way, I have put no restrictions on the way in which the groups may develop.
As regards the configurations in the Western Board area, the groups there were formulated following discussions with the primary care professions and service users. There is widespread agreement on the configurations in that area. Perhaps someone will convey that answer to the Member who raised the point but who has since left the Chamber.
On the importance of the overall allocation to health, I point out again that five sixths of the new resources for health and personal social services have gone simply to meet inflation — the rising costs of the existing services. The remaining amounts have been insufficient to keep pace with demand. The position has been exacerbated by real reductions in baseline funding extracted over the past two decades. Moreover, any available funding has been subject to the Barnett squeeze, which has led to lower levels of increases being made available here. During the 1990s, health and personal social services spending per head grew by some 25% in real terms. In England, growth amounted to 35%. Matters have worsened since then, and the allocations for the current spending review period widened the gap.
The service needs not just more resources but greater certainty about future funding levels, which will allow meaningful long-term planning. The NHS has had the advantage in recent years of greater resources and firm baselines for the future, and I hope that this year’s spending review will give us the opportunity to achieve that and that we can work to make that happen.
The end of GP fundholding on 1 April will have no adverse impact on services. People will still go to their GP or primary care professional and receive the same services that they currently receive. It is important to reiterate that all the boards have agreed that all services currently provided by GP fundholders will be maintained until the local health and social care groups can decide on their future. We have held discussions with GPs, nurses, social workers, pharmacists, boards, trusts and others to discuss the detail of the arrangements.
The formal consultation on ‘Building the Way Forward in Primary Care’ ran from 11 December 2000 until 31 March 2001, and during that period departmental officials were involved in over 50 meetings, seminars and workshops. At that time I met the General Practitioners’ Committee of the British Medical Association (BMA) and the Royal College of General Practitioners. I met the General Practitioners’ Committee again in January 2002.
Prior to that, I was involved in a series of discussions with a wide range of health professionals and managers, including the BMA and the Royal College of Nursing, to listen to views about primary care arrangements, and there has been ongoing contact with officials. Many of the concerns that were raised have been addressed. Services will be maintained at the end of fundholding, staff will continue to be employed and professional staff will form a large part of the local health and social care group management boards. I have received a request from the BMA, the Royal College of Nursing and the Royal College of Midwives for me to meet them to discuss their concerns, and I have agreed to do so on Wednesday.
In answer to the point raised by Dr Hendron, that letter arrived by post on 7 March.
I shall proceed with the setting-up of the new local health and social care groups. The level of support expressed during the consultation exercise last year was extensive. Recent expressions of support have come from the Association of Directors of Social Services, the advisory committee for professions allied to medicine (PAM), the directors of nursing of the four health boards, the Foyle area nurse practitioners and general practice forum, community practitioners in the Health Visitors’ Association, and Armagh City and District Health and Social Services Community Forum.
Dr Hendron mentioned opposition from Dr Harold Jefferson. However, I have also received support from some of the commissioning pilots, and there may be differing opinions on that. Many of those involved in the pilots have indicated that they will support the proposals that I am putting forward. I am proceeding because of the success of the commissioning pilots on which the new groups are based. I want to put more money into front-line services so that local people and local health professionals can work together in a multidisciplinary fashion to make local decisions about local services.
The issue of a wider structural change in health and personal social services remains firmly on my agenda. In developing health and personal social services that are fit for the twenty-first century, it is important to ensure that the organisational structure is appropriate for the efficient and effective delivery of services. Structures must support the close working of all parts of health and personal social services and also facilitate communications between health and social services and education, housing and other key public services. I believe that the new groups will allow that to happen.
The Executive’s wish to review public administration here, and the issues surrounding the development of acute hospital services — and the mention made there of the wider structures — provide the wider context within which any proposals for organisational change must be developed. The new groups have been set up to be flexible enough to be accommodated within any wider structural changes.
Similar groups that were established in Wales, Scotland and England were originally subgroups of existing Health Service bodies. I am aware that if the new groups are to succeed, it is essential that funding be made available for the development of primary care services. Next year, I intend to deploy additional resources towards primary care developments. I have discussed my proposals with the Committee.
The amounts will increase by £2·5 million in 2003-04 once the balance of the money currently tied up in GP fundholding management allowance has been released.
In conclusion, local health and social care groups represent the best option for primary care to assume a central position in health and social services. They provide the first important step towards a more inclusive and co-ordinated system for planning, commissioning, and delivering services. They will ensure that local people and local health professionals work together, in a multidisciplinary fashion, to make local decisions about local services. I hope that we can all work together in a spirit of co-operation, as we have been able to do on some of the wider questions, to ensure that the groups succeed. It is in the interests of patients and all the people that they do.

Dr Joe Hendron: I thank the Minister for being present for the entire debate. I listened carefully to what she had to say. I also thank all my Assembly Colleagues who participated.
Dr Adamson mentioned early diagnosis and other important primary care issues, such as multidisciplinary groups and equality of partners in the new groups. Early diagnosis is extremely important. Mr McCarthy was positive in his comments about the need for a first-class service. However, he did say that we do not have a clear vision. He also described the way in which the groups are to be set up as quangos. Ms Morrice made positive comments, although I think that she said she was going to vote against the motion. However, I may have taken her up wrongly. If she is to vote against the motion, I do not understand why.
Mr McCartney spoke about waiting lists, which is a massive subject in itself. He said that we have the longest waiting lists in Europe. He also talked about the bureaucratic set-up in the Northern Ireland Health Service and mentioned various bodies that have expressed concern. Mr McGrady spoke from his experiences with bureaucratic structures, resources and waiting lists. He talked especially about pain and suffering, which is a key point as it happens daily. He also said that people are dying.
Dr Birnie focused on the groups themselves and on enhancing the power of the boards, which is also a key point. It is a top-down, not a bottom-up, structure. We are increasing the powers of the boards, and the Member mentioned the word "diktat" in that regard. Mr Shannon talked about cancer problems and about trying to get appointments with nurses in GPs’ practices. He also mentioned the massive pressures on primary care services. We all know that there are asthma clinics, clinics for the elderly and many other clinics, but we are concerned with the overall strategy.
Mr John Kelly made some points on which I wish to comment. First, he said that I had not declared my interest in primary care. On a point of order, in January 2001, during a similar debate, I definitely declared that I retained a slight interest in primary care. I apologise if I have misled anyone in the Assembly, but if I did, I did so inadvertently. I have never gained one penny through fundholding, and, as far as primary care is concerned, I shall not be involved in it for very much longer. However, I shall not go into that.

Mr John Kelly: Will the Member give way?

Dr Joe Hendron: I shall not give way. I normally give way to Mr John Kelly, but not when I am summing up.
Mr John Kelly also said that we had heard from no representatives of those who are in favour — in favour of what? We are all in favour of the new primary care groups. The discussion has been going on for years, ever since John McFall was the direct rule Minister. If Mr John Kelly is saying that all the organisations that we are discussing, as well as certain other groups that I listed in my opening speech, oppose the Minister’s decision, I have already dealt with them. Organisations such as the Northern Ireland Trust Nurses Association and the directors of social services, with whom we met last Wednesday, are well informed. Although they are not at the coalface, they support the new measures, just as we all support them. However, they are not querying the fact that the guidelines could have been laid down long ago. That is the key point.

Mr John Kelly: Will the Member give way?

Dr Joe Hendron: Sorry, I am summing up. I cannot give way because I only have a few minutes left.
Mr Berry talked about turning back the clock and said that fundholding was dead. Of course, he is absolutely right. Mr John Kelly and Ms Ramsey queried having this debate in the first place. I point out to them it is only in the last six or seven weeks that details of the primary care groups have come to the people concerned, so it was impossible for the Committee for Health, Social Services and Public Safety to see every group that wanted to meet us. We have met as many groups as possible and I — [Interruption].

Mr Speaker: Order. It is not in order for Members to interrupt a Member who is speaking. All Members got reasonable hearings, so I do not see why the Chairperson should not get a reasonable hearing too.

Dr Joe Hendron: As Chairperson, I have tried to facilitate every member of the Committee, including Mr John Kelly, with regard to the people whom they wanted me to meet in the past. However, with the key date being 1 April it was impossible for the Committee to meet all the groups. The Minister and her Department should have brought the groups along with them during the last 12 months.
Mr Hamilton talked about an amendment and about an opportunity missed — most of us would accept that. Mrs Iris Robinson talked about the broad support for the Minister’s original model. However, there was no broad support for that model; there was broad support for the model in ‘Fit for the Future’, which was brought forward by John McFall.
In ‘Building the Way Forward in Primary Care - Summary of the Responses to the Consultation’, the Minister refers to "respondents". As I said to her last week — if a wee man in the Cavehill had written a letter about the future of primary care, he would have become a respondent. All groups — primary care, nurses, midwives — are referred to as "respondents" and, according to the document, most of them are supportive.
Mr Gibson talked about the legacy of bureaucracy and about things being imposed. Ms Armitage’s grave concern was shared by most of the Committee for Health, Social Services and Public Safety, and she wants no fudge. My Colleague, Mr Gallagher, talked about the workload on primary care, increased public expectation, resources and, above all, accountability.
The Minister described the primary care groups in detail. The Assembly supports primary care groups. Primary care-led health services are happening in these islands and in western Europe, and we agree with what the Prime Minister, Tony Blair, said about such a service. The reason for the amendment in January 2001 was to allow for a seamless transition.
The Minister said that the committees were statutory committees of the boards — I hope we are not playing with words. There was no primary legislation involved. Of course, the matter is within the statutory arrangements of the boards, but they are still committees of the boards. I hope — it will not be before the election, but perhaps following it next year — that there will be primary legislation in the Assembly to give power to the people at the front line, so that there will be a truly primary care-led Health Service in which all professionals are equal and have direct links to the community.
I will not raise the issue of the composition of the boards now. I will finish by saying that we want the best primary care for the people of Northern Ireland and that it is up to the Minister and her Department to bring people along with them. Mr John Kelly mentioned groups that we have not spoken to: all of them support the new ideas for primary care. Maybe it is not too late, but it is now over to the Minister and her Department.
Question put and agreed to.
Resolved:
That this Assembly expresses its grave concern about the future of primary care services in Northern Ireland and calls on the Minister of Health, Social Services and Public Safety to take prompt action to allay the serious concerns of the professions and staff working in Health and Social Services about the arrangements for local health and social care groups.

Agriculture Industry

Mr George Savage: I beg to move
That this Assembly urges the Minister of Agriculture and Rural Development and the Executive to consider the implementation of measures which will sustain the viability of the agriculture industry in Northern Ireland.
It is now some 15 months since I last introduced a major motion on agriculture to the Assembly. That was on 5 December 2000. At that time, the House unanimously supported the motion, which called for more proactivity on the part of the Department to redress the sorry state that agriculture was in at that time. Unanimity is not common in the House, so, when it occurs, Ministers should always take special note.
At that time, I proposed the adoption of a farmers’ early retirement and loan scheme, which — if I may paraphrase what would be a complex piece of legislation — would set out to enable older farmers to retire with dignity, a lump sum and a pension and enable young blood to enter the agriculture sector with new ideas, new perspectives and a business education behind it. The legislation that I proposed was based on the schemes currently operational in Denmark and France, so we were not in uncharted waters. Indeed, I had been in close contact with the Agriculture Ministries in both countries as well as with the appropriate directorates in Brussels and the now demised Ministry of Agriculture, Fisheries and Food in London — a Ministry axed because of its lack of proactivity.
I was enthused about the scheme from the contact that I had with its practitioners through my membership of the Committee of the Regions in the European Union. The most important feature of the scheme was that it would provide a proper and proven framework around which the farming sector could restructure itself. The need for the scheme was great in December 2000 when we were in the middle of an unprecedented crisis in agriculture — foot-and-mouth disease was still to come. However, the need for the scheme is even greater today.
Oliver Cromwell, a gentleman whom I am careful about quoting here, once said to Parliament
"No man mends his house in the hurricane season."
We may not be in a hurricane season. There may have been a slight improvement in farm incomes. I emphasise the word "slight", because I challenge the Minister and her colleagues to explain to the House how they would live on the average improved income of only £5,800 a year that farming families now receive. Although we may not be in the midst of a hurricane, we are certainly not in fair weather yet.
However small or temporary the respite between crises may be, it provides a chance for us to act decisively and not in the midst of chaos. That is why I am advocating action now. I called for action in December 2000, and I am doing so again 15 months later. It is the duty of the Government to provide a legislative framework to enable farming to restructure. A new era for farming is slowly emerging. It is an era driven largely by Europe, where the subsidy culture will soon be a thing of the past. It is an era in which the Ministry of Agriculture, Fisheries and Food’s successor Department, the Department for Environment, Food and Rural Affairs, has already set out a new role for farmers as custodians of the countryside.
The collapse of the former farming economic infrastructure has been driven by powerful forces. The strength of sterling has driven down our international competitiveness. There has been a disempowerment of the farming sector, and the sector has not restructured as quickly as the food-based industries that it sustains. As a consequence, farmers have been in a poor negotiating position with the big supermarket chains and the even bigger capital that they represent. World food prices have fallen when there has been economic prosperity for every other sector of the economy.
The farming sector has fared poorly compared to other sectors. People have difficulty identifying with the hard-pressed farmers. In addition, our farmers face competition from the Third World, the Far East and Europe, and trade liberalisation makes the problem worse. The report of the policy commission on farming and food was clear on the remedy for a sustainable future.
However, farming must become more business- focused. The policy commission’s report said that it could become a vibrant, profitable business, attracting investment and new entrants by listening to the people who consume its products and conserving its most valuable asset — a healthy and attractive countryside.
We cannot reorganise farming into viable, healthy business-orientated, economically efficient units unless we restructure it, and that can be done only by introducing an early retirement scheme for farmers and encouraging young people who have been trained in agricultural colleagues and farms to take up the challenge and by providing Northern Ireland farming with a business plan. I am advocating both of those.
If the Minister does not introduce an early retirement scheme and provide a framework for restructuring, that is tantamount to saying that we will abandon farmers to the powerful economic forces I have mentioned. Some farmers will sink, and some will swim. That is not a recipe for ordered restructuring — it is a rout. It is an abdication of the duty we owe to an important part of our community that depends on agriculture for its living.
I remind the House of the knock-on effects of that. Only 0·9% of the British electorate is actively engaged in farming. In Northern Ireland about 85,000 people are engaged, one way or another, in agriculture. The building trade employs only one third of that number. As an employer, farming is second only to manufacturing. For reasons of economic prudence, we should introduce an early retirement scheme and a loan scheme. Most Members would join me in doing that for common decency alone.
I do not propose to labour the details of the scheme today — Members have heard me talk about it often enough. They can read the details in the Hansard of 5 December 2000, or they can read one of the many recent articles in the press. The Minister has appointed consultants to look at this, and I want to convince the House that we need to act on it. Where is their report? We have been waiting fifteen months, and that is too long. We must not be like Nero, fiddling about while Rome burns.
I want to add some important provisos to the scheme that was set out in December 2000. We must tie the implementation into restrictions on production. Farmers are sometimes obsessed with producing more and more. What is the point of producing more, if it cannot be sold? That only drives the prices down. During the Northern Ireland Institute of Agricultural Science conference it was said that only 22% of farmers saw a need for radical change towards a market-oriented entrepreneurial culture, and that is very worrying. One of the main reasons identified for the failure of farmers is that they do not live in the real world.
The Government are sending out confusing signals. We must have a 10-year business plan for agriculture in addition to the early retirement and farm loan schemes. They are essentially two sides of the one coin, and they go hand-in-hand.
That 10-year plan cannot be definite. What can be definite in this fast-moving world? However, the plan must "best guess" the direction that world agriculture will take by using the most sophisticated tools available in market trends analysis and market intelligent methods. That is a major task.
Although the plan cannot be prescriptive, it must give farmers an idea of the realistic market options available in the next 10 years so that serious and viable planning can take place in agriculture. Only then can a proper investment climate be created. It is the duty of the Government to give a lead. However, the issues are of such dimensions that the matter should be taken on by the entire Northern Ireland Executive and not just by the Minister of Agriculture and Rural Development. Given the importance of the agrifood industry as well as the agriculture sector, this is a strategic matter for the entire Northern Ireland economy.
Two avenues are open to us with regard to the financing of an early retirement scheme. Fifteen months ago, in my original submission to the Minister, I demonstrated how the scheme could be self-financing. If loans were restricted to those farmers with indebtedness of over £20,000, that would put some £1,440 million into circulation. The total capital asset value of Northern Ireland farms is over £10·5 billion, a massive sum, compared with the total farmers’ indebtedness of some £700 million, that is less than 7% of the capital asset value of the farms. The scheme’s best feature is that it would lock the capital asset value of Northern Ireland farms at normal interest rates, which would earn the banks or financial institutions charged with the administration of the scheme some £42 million a year. The scheme itself would cost some £20 million a year to operate in the first five years, and after that the costs would diminish significantly.
Surely it is not beyond the imagination of man or Minister to tell the banks that they would generate a massive sum by simply operating the scheme and that they would be expected to plough a significant part of that back into the industry. Given the sheer volume of business, it might be possible for the banks to pay the total cost and still pocket profits of £22 million a year.
Another option might be to redesign the regional policy of the United Kingdom, using Northern Ireland, as has been done on many occasions, as a test case, to bring the scheme in on the back of a permitted soft loan European strategy within the constraints of the European Union’s Agenda 2000 regulations.
This is a matter for the entire Executive, because the issues raised involve a significant level of expenditure and strategic planning decisions. We must position ourselves in the world market in a way that ensures viability in farm size and efficiency. Adequate business planning requires imaginative leadership, and now is the time for that. Many stories have been told about what happened to the agriculture industry. Having listened to the previous debate on health, agriculture must not get itself into the same position. We are all aware of the crisis facing the Health Service. I hope that the proposal will be examined comprehensively and that with a common-sense approach, the agriculture industry can be brought back onto a level footing.

Mr Speaker: So inspiring has the Member been, that there are now twice as many Members who wish to speak on the list as there were when he opened the debate. I have, therefore, no option but to put a limit on the speaking time available to Members, which will be eight minutes.
That is not a minimum requirement for Members who wish to speak, but a maximum requirement. That limit does not apply to Mr Savage, who moved the motion, or to the Minister who will have the usual time for their winding-up speeches.

Mr P J Bradley: I support the motion, but I do not imply that nothing has been done or achieved by the Minister or the Department of Agriculture and Rural Development. First, we should look at when the downward spiral in farming began. The mid-1990s — 25 years into direct rule — was the beginning of the end for many farmers. The Minister, the rest of the Executive and the Agriculture Committee have worked to deliver new hope to the farming industry, but in the three short years since it became locally elected people’s responsibility to address our problems, we have had the disruption of foot-and- mouth disease.
I attended an Ulster Farmers’ Union meeting on Tuesday night, and I was asked to convey publicly, on the union’s behalf, its gratitude for the Minister’s efforts during the foot-and-mouth disease crisis. Since November 1999, the House has experienced periods of suspension, so much has been achieved in a few working months. As a member of the Agriculture Committee, I am fully aware of the tremendous amount of work that has been done to get the agriculture industry working again. The Minister, the Department of Agriculture and Rural Development and the Committee have worked together on many important issues. Since November 1999, small farmers who were neglected for more than a quarter of a century have finally been recognised. Milk producers with a quota of less than 250,000 litres were given additional quota. The 90-head limit on the beef special premium (BSP) was removed, and new protection measures were introduced for producers with fewer than 30 heads of cattle. A new milk scheme was introduced, and beef national envelope funds were revised and split sixty-forty between suckler producers and heifer producers.
Benefits for the long-term survival of the industry inevitably come about as a result of the cross-border animal health programme that the Minister is pursuing. The introduction of the new beef quality initiative will also ensure that Northern Ireland produce is of the best quality. A vision group was established, and its action plan should be up and running by June 2002. Work is under way to secure a future for the next generation and, as the Deputy Chairperson of the Committee has said, it is the hope of many, including myself, that developments will include a combination of a new entrants’ programme and an early retirement scheme.
Many other developments have taken place that are in the interests of the farming industry and broader rural issues. Those include: the reduction of red tape; the securing of funding; the backing of rural development; the Minister speaking up in Europe; support for the fishing industry; and the securing of regionalisation for Northern Ireland during the foot-and-mouth disease outbreak. So much was achieved in a short time. I support the motion, but rather than ask the Minister to consider the implementation of measures to sustain viability, I ask that she continue to implement measures that will allay the concerns of all who are interested in the future of the agriculture and fishing industries for the betterment of rural society overall.

Mr Speaker: Having only a minute until Question Time, I propose that the House takes its leisure for that time.
Oral Answers

Education

Mr Speaker: Question 7, in the name of Mr McGrady, question 10, in the name of Mr Dallat, and question 20, in the name of Mr Gibson, have been withdrawn and will receive written answers.

Vocational GCSEs

Mr Ken Robinson: 1. asked the Minister of Education to detail what action he has taken and any plans he has made to promote new vocational GCSE examinations.
(AQO972/01)

Mr Martin McGuinness: The Council for the Curriculum, Examinations and Assessment (CCEA) will offer new vocational qualifications known as GCSE double awards from September 2002. A series of seminars and workshops have been arranged to ensure that staff in schools and support agencies are fully prepared. Promotional posters, teacher and pupil information packs, and fact sheets covering each vocational area will be widely distributed. Information will also be available on the CCEA web site.

Mr Ken Robinson: The leading examination boards — Oxford Cambridge and RSA Examinations (OCR), Edexcel and CCEA — have all announced the launch of new GCSEs in vocational subjects to replace the existing GNVQs in an effort to give parity of esteem to practical subjects such as engineering, manufacture and design. The Westminster Government plan to designate 1,500 schools as specialist engineering schools with additional funding of £100,000 each — over £300 extra per pupil. Will the Minister extend this scheme to Northern Ireland in an effort to enhance and promote the strong tradition of engineering and manufacturing education in the Province?

Mr Martin McGuinness: I am prepared to consider the scheme of which the Member speaks. I have no first-hand knowledge of it, but when I have more information I will give it consideration.

Teachers’ Health and Well-Being Survey

Ms Sue Ramsey: 2. asked the Minister of Education to outline (a) when he intends to publish the findings of the teachers’ health and well-being survey; and (b) what action he intends to take as a follow-up.
(AQO967/01)

Mr Martin McGuinness: The draft report, which was commissioned by management side of the teachers’ salaries and conditions of service committee, should be ready by the end of this month. It will be published after management side has discussed the findings with teachers’ side. While the follow-up action will depend on the findings, my Department, the employing authorities and teacher representatives will be giving a high priority to the report’s recommendations on a strategy for improving teachers’ health and well-being.

Ms Sue Ramsey: Go raibh maith agat, a Cheann Comhairle. The Minister has covered part of my supplementary question. Does he have any idea, from what is in the draft report now, whether the present arrangements need to be improved?

Mr Martin McGuinness: The employing authorities already provide a range of in-house services to teachers, including formal arrangements with agencies providing specialist help in areas such as bereavement and relationship problems. The report will identify ways in which the present arrangements can be improved as necessary.

Mr Billy Bell: Does the Minister accept that stress is one of the main causes of the high levels of teachers’ absence through sickness? It cost the education budget over £15 million in 2000-01. Therefore, urgent action is needed. Can the Minister tell the House what action he intends to take to deal with this problem?

Mr Martin McGuinness: The work that has been undertaken and the draft report, which will be ready by the end of this month, will deal with all of the issues of which the Member speaks. Then it will be a matter of the management side and the Department of Education giving due consideration to all of those issues. The issue of teacher stress and welfare is one that I regard as a top priority in my Department. I have met many representatives of the teachers’ unions, and I am aware of their concerns. The report will go some way towards addressing their concerns.

Refurbishment of Youth Clubs

Mr P J Bradley: 3. asked the Minister of Education, pursuant to his announcement on 12 September 2000, to outline the procedures that are necessary to enable youth club committees to avail of finance to refurbish their premises.
(AQO952/01)

Mr Martin McGuinness: The extra finance that I announced on 12 September 2000 was for a facelift scheme to allow youth clubs to refurbish their premises. The funding was available through the education and library boards. The scheme ran during the year 2000-01, and £500,000 was released, although the initiative was heavily oversubscribed.
In September 2001 I announced that I had secured substantial additional funding of £1·5 million each year over the next three years from the Executive programme funds. That funding is to be used for health and safety works, improvement schemes, including better disabled access and the installation of computer equipment. Seventy-four youth organisations have applied for grants so far. I encourage other clubs, particularly those in disadvantaged areas, to contact the Department to avail of the next allocation of funding in the 2002-03 financial year.
Youth club committees are also entitled to apply to the Department for financial assistance at any time under the capital schemes for youth sector. Limited funding is available.

Mr P J Bradley: I have just learned about the new funding. Will the Minister confirm that local divisional youth officers are au fait with the new funding? Is there an obligation on them to advise youth club committees in their areas about that funding? Is the Minister depending on those officers to promote the funding?

Mr Martin McGuinness: Further information on the scheme and application forms can be obtained by contacting Youth Services Branch at the Department of Education. This is an open-ended scheme, and applications can be made at any time.

Mr Jim Shannon: I am interested in this scheme. Will the Minister indicate if funding for youth club committees will be spread equitably? What criteria will be used to ensure that all moneys are allocated fairly to the Unionist community? Have targets been set, and what steps will be taken to ensure that youth clubs in Unionist areas can source the moneys?

Mr Martin McGuinness: There will be equality, and decisions will be taken on the basis of need in individual areas. When I come to Question Time, I always feel regret when people come forward with questions which attempt to sectarianise a vital area of work in education. We had an example of that in relation to the schools capital building programme, and now we have it again. My administration is totally committed to treating people fairly. We have had too much injustice, unfairness, inequality and discrimination in the past — far too much for me to even begin to think that it would be a sensible way forward for my administration.

Teachers’ Pay and Conditions

Mr John Kelly: 4. asked the Minister of Education what action he intends to take in relation to the proposal by teachers’ organisations to hold an independent inquiry into teachers’ pay and conditions.
(AQO971/01)

Mr Martin McGuinness: Following separate meetings with management side and teachers’ side on 13 December 2001, I received a letter from teachers’ side suggesting that it would be appropriate for the negotiating committee to take forward an inquiry into teachers’ salaries and terms and conditions of service. Under the proposal, both sides would agree the terms of reference, the personnel and the timescales. They would also receive the report’s recommendations for negotiation in the normal way.
I arranged for senior officials to meet with teachers’ side on 25 February to discuss the proposal. The next step is to complete discussions with management side on teachers’ side’s proposal and to reach an early decision.

Mr John Kelly: I thank the Minister for his comprehensive answer. Does the Minister support the teachers’ proposals for an inquiry?

Mr Martin McGuinness: The approach proposed by teachers’ side seems to be a reasonable way forward, but I will await the views of the employing authorities before making any final decision.

Mr Tom Hamilton: The Minister informed the Committee for Education on 16 January 2002 that he would make a decision regarding an independent inquiry shortly. We are still waiting. Can he explain the reason for the long delay, which is totally unacceptable, given that the issue was first raised in July 2001?

Mr Martin McGuinness: The recent proposals from teachers’ side were significant. My Department had to examine them before they could be discussed with management side. I hope that the issue can be dealt with expeditiously.

PricewaterhouseCoopers

Ms Patricia Lewsley: 5. asked the Minister of Education to detail (a) the number of staff from PricewaterhouseCoopers who worked on assignment or secondment to his Department or to the education and library boards during the past five years; (b) the cost of the total fees paid by his Department and/or the boards to PricewaterhouseCoopers; and (c) what percentage of total consultancy work allocated by his Department and the boards went to PricewaterhouseCoopers over the past five years.
(AQO955/01)

Mr Martin McGuinness: Today I replied to the Member’s original written question, which asked for the same information. In the letter that accompanied that reply I apologised for the unacceptable delay in providing that information. For Members’ benefit, I will place a copy of that correspondence in the Library.

Ms Patricia Lewsley: I thank the Minister for his answer and for the details of his letter. Was that consultation work obtained through the proper, open tendering process?

Mr Martin McGuinness: I explained in the letter that the information requested by the Member was not available in a readily accessible form. Although it was relatively easy to ascertain how much money was paid in fees to individual consultancy companies by the Department, it was less easy to obtain that information for the five education and library boards. When the data was received from the boards, it had to be cross-checked with data obtained from departmental sources to ensure that information was not counted twice.
There were also delays in establishing information on the numbers of consultants, as that could not be determined without undertaking a major exercise at a significant cost in staff resources. In addition, as my letter states, some of the key papers were mislaid by one of my officials, and that caused further delay.
The answer to your question about tendering is "Yes".

Green Schools Programme

Mr Mick Murphy: 6. asked the Minister of Education if he intends to initiate a programme similar to the green schools programme operated by the Dublin Government.
(AQO969/01)

Mr Martin McGuinness: The green schools programme is one element of the European-wide eco-schools programme. I am pleased to say that over 120schools here have already registered in the eco-schools programme since its inception.

Mr Mick Murphy: Does the Minister agree that the schools programme in the Southern part of this island is a superb example of improving environmental awareness at an early age? No doubt the Minister can see, as I do, increased opportunities for significant North/South links, and, perhaps, the potential for an Irish language edition of the eco-schools programme.

Mr Martin McGuinness: Absolutely. There is no doubt that over 750schools, both primary and secondary, are registered with the programme operated in the South by An Taisce — the National Trust for Ireland. There is significant interest in environmental issues here also, as can be seen from the number of schools that have registered with the eco-schools programme.
The current review of the curriculum also provides an important opportunity to define how all subjects, particularly geography and science, can provide scope and opportunities for young people to become responsible custodians of their environment.

Pre-School Nursery Places

Mr Edwin Poots: 8. asked the Minister of Education what percentage of fully funded pre-school nursery places are available in each board area.
(AQO966/01)

Mr Martin McGuinness: Complete data for the current school year are not yet available. However, for the year 2000-01 the percentages based on the three-year-old population are as follows: Belfast 90%; Western 73%; North Eastern 66%; South Eastern 65%; Southern 71%; and the overall figure was 72%. It is anticipated that, during this academic year, places will be available overall for at least 85% of the cohort.

Mr Edwin Poots: In his response to a previous question, the Minister talked about equality and treated with disdain those who asked questions about fair treatment.
It is clear from the figures he has given that schools in the Unionist community that are within the North Eastern Education and Library Board and South Eastern Education and Library Board areas are being discriminated against. In Downshire, which is in my constituency, only around 25% of children are being offered pre-school places. When are children in rural constituencies in those board areas going to get fair treatment and equality and be offered the pre-school places that they have been denied? Schools, including Riverdale Primary School, that have requested pre-school places have been denied that opportunity by the pre-school education advisory group (PEAG).

Mr Martin McGuinness: In formulating their development plans, PEAGs are required by the Department of Education to give particular regard to the needs of rural areas. Prior to the expansion programme, the level of provision tended to be lowest in those areas. However, while there is a good network of nursery schools and units, pre-school playgroups and private day centres, local circumstances may be such that it is simply not possible for the intended level of coverage to be reached in some rural areas.
In some areas of the Lagan Valley constituency it has not been possible to achieve the intended level of coverage. That is largely due to local circumstances. For example, I am aware of one large village in Lagan Valley where none of the existing playgroups has applied to be allocated pre-school places. That operates to depress the overall level of coverage that can be achieved in that area. The Department is working with the South Eastern Education and Library Board PEAG to investigate what can be done to increase the level of provision in such situations.
I am also aware that there has been much discussion about the issue of statutory settings, which are established in the controlled and maintained sectors. I am aware of the view that decisions about the funding of new statutory provision have discriminated against the controlled sector. Both sectors have benefited from the creation of new nursery provision under the pre-school education expansion programme.
There are other initiatives, such as Belfast Regeneration — formerly known as Making Belfast Work — and the EU special support programme for peace and reconciliation. There are currently 155 controlled, 95 Catholic maintained, 13 grant-maintained integrated and one non- Catholic maintained nursery schools and units in a total of 264. A further 33 new projects of all management types are currently being developed. I emphasise that all pre- school education provision is open to all children. There is considerable integration of attendance in that sector.
The issue must be dealt with in its proper perspective. The Assembly must acknowledge that in certain circumstances there are particular individual situations that do not reflect the overall picture.

Mr Billy Armstrong: Can the Minister clarify whether the fully funded pre-school places are full-time or part-time? How is that provision monitored and evaluated in order to ensure that adequate standards are achieved across all areas?

Mr Martin McGuinness: Pre-school provision is monitored by the PEAGs, which are attached to the five education and library boards. It is monitored consistently. The Department of Education takes a keen interest in that. Our perspective is that it is essential to provide as much provision as possible. The progress that has been made in the last several years has been rapid. The provision is monitored and inspected. If people want to ask specific questions about specific circumstances, possibly peculiar to their own constituencies, the Department will be happy to answer those questions.

Academic Selection and 11-Plus Test

Mr Danny Kennedy: 9. asked the Minister of Education what assessment he has made of the relationship between the abolition of academic selection and the abolition of the 11-plus test.
(AQO1012/01)

Mr Martin McGuinness: I welcome the Member’s question, because it is at the heart of the current debate on post-primary arrangements. The 11-plus test exists only because Northern Ireland has a system of post-primary education that allows grammar schools to select the pupils that they want and reject the rest.
There is clear demand for the abolition of the test, but that cannot happen unless decisions are taken on the key issue of academic selection. Retaining academic selection and abolishing the test would require some other form of selection by grammar schools. Whatever system is used, it will perpetuate many weaknesses that have been identified by research into current arrangements.

Mr Danny Kennedy: Will the Minister accept that statements he has made in the House and in public to the effect that it is important to realise that the abolition of the 11-plus test cannot take place unless academic selection is also abolished are, in fact, inaccurate? Will he also accept that it is possible to have academic selection by other means?

Mr Martin McGuinness: The consultation process, which ends on 28 June, provides a golden opportunity for people to make suggestions. I have made it clear from the outset that I want people to respond to that consultation and to give their views on the Burns proposals. I have also invited people to suggest modifications and alternatives for consideration by my Department.
Today I launched a video and other consultation materials as a vital aid to discussion. This is the most comprehensive consultation on any issue since the Assembly’s establishment. However, research by Prof Tony Gallagher, Prof Alan Smith, Save the Children and Prof Gardiner clearly states that new arrangements should not perpetuate the weaknesses that have been identified in their research. That is a danger.
However, the consultation is meaningful and real and offers a real opportunity for the entire community to have a say in future arrangements. We do not have a modern education system of which we can be proud. We must recognise that the arrangements put in place over 50 years ago were relevant to the last century. That system is not relevant to the needs of our children, be they from the Shankill Road, from the Bogside, from the Falls Road, from Ballymena or from Portadown. We must face that reality.
People must also face the crux issue of academic selection. We must confront the facts; only 2% of children from the Shankill Road have a grammar school education, and only 8% of children who attend grammar schools come from disadvantaged areas. Those are huge issues.
I appeal to everybody, both in the Assembly and outside, not to become involved in conflict or division on this issue. Everyone has a duty and a responsibility to rise above that. This is about more than structures; it is about putting children at the centre of our thinking and establishing an education system that will allow them to believe in themselves and to succeed.

Mr Gerry McHugh: Go raibh maith agat, a Cheann Comhairle. I agree with the Minister that we must focus on prioritising children. Putting children first, rather than putting them forward as failures at 11 years old, is the key to the debate. Does the Minister acknowledge that academic selection is, in fact, academic rejection for the majority of children?

Mr Martin McGuinness: Yes, I do. The reality is that academic selection for some children means academic rejection for many more.
Moreover, research has shown that academic selection at age 11 prematurely closes down opportunities for the majority of pupils. It creates a sense of failure and results in a loss of self-esteem and confidence at a stage of their educational, social and emotional development when every encouragement should be given. Teachers have to work extremely hard to restore that loss.
We should also understand that children are individuals whose educational development progresses at different rates. We recently heard that from Prof Gerry McKenna of the University of Ulster. He made a significant point, which is backed up by Prof George Bain, the vice- chancellor of Queen’s University. Only 50% of students come via A level to the new University of Ulster. Where do all the others come from? That is the big question. That clearly shows up the extra and incredible abilities of our young people. It is important that options are kept open until a child’s needs and aspirations have developed more fully.
I have heard it suggested that the idea that every child can be a success is pie in the sky. On the contrary, every child can be a success. I have been in special education schools with autistic children, and it has done my heart proud to see a child on one day being able to count to six and on the next day to count to eight. That is how success must be measured. Children have different abilities, and unless we get our heads around that, and realise that our challenge is to provide an education system which opens doors for all of our children, we will always struggle against the backdrop of an education system that is not world class and which lags behind New Zealand, Korea and many other such countries.

Mr Sammy Wilson: I am sure that the people of the Shankill Road will be touched and pleased to hear about the Minister’s concern for their children’s future. It is a pity that he did not share that concern when his associates bombed their parents not so long ago.
How is the Minister’s consultation video to inform the debate on the issue of post-primary education? Eighty per cent of that video is directed towards the promotion of his party political point of view and of the Burns proposal.
If the Minister rejects academic selection, on what basis does he expect youngsters to be selected for oversubscribed schools? Is he in favour of social selection based on their parents’ ability to pay, their contacts, or their ability to buy a house in the proximity of the popular schools?

Mr Martin McGuinness: The objectives of the video and household response form are to provide clear and objective information on the consultation arrangements and on the Burns proposals, to inform the debate and to explain to people how they can respond. The video will be sent to schools, further education colleges and community groups, and it will act as an aid to discussion on the proposals. It will also be sent to public libraries and made available to the public.
The content of the video sets the context for the review by explaining why change is necessary and by referring to the weaknesses identified by the Gallagher and Smith research and the Save the Children research. The Burns proposals are explained, and answers are provided to frequently asked questions about them.
The video puts the Burns proposals in the context of the wider review of post-primary education and invites comments. The response form asks questions on key issues and includes a summary of the main proposals made by Burns, with information on how everyone can respond to the consultation.
The materials we launched this morning explain the key elements of the Burns proposals and include views and concerns expressed by a number of education professionals about the document and about current arrangements.
A wide range of views is represented. The materials serve their purpose, which is to provide information about the Burns proposals and the context of the review of post-primary education in order to stimulate discussion.
Last week, a 10-and-a-half-year-old child uttered one of the most powerful statements that I have heard in the course of this debate. During the Save the Children research, she was asked what the 11-plus meant to her. Her words were more powerful than those of any adult who has articulated his or her views on selection. She said that if she passed, she would go to a smart school, but that if she failed, she would go to a stupid school. I rest my case.

Mr Speaker: Order. Time is up for questions to the Minister of Education.

Health, Social Services and Public Safety

Belvoir Park Hospital: Radiotherapy

Mr Speaker: We will now move to questions to the Minister of Health, Social Services and Public Safety. Question 1, standing in the name of Mr Byrne, question 3, standing in the name of Rev Robert Coulter and question 12, standing in the name of Mr Gibson, have been withdrawn and will receive written answers. Question 9, standing in the name of Mr McHugh, has been transferred to the Office of the First Minister and the Deputy First Minister. Question 17, standing in the name of Mr Conor Murphy, has been withdrawn and does not require a written answer.

Ms Pauline Armitage: 2. asked the Minister of Health, Social Services and Public Safety if she has any plans for, or if she would consider, using part of Belvoir Park Hospital for radiotherapy treatment only.
(AQO961/01)

Ms Bairbre de Brún: Go raibh maith agat, a Cheann Comhairle. Ag teacht le Tuarascáil Campbell, soláthrófar seirbhísí radaiteiripe ón lárionad réigiúnach ailse atá le tógáil ar shuíomh Ospidéal Chathair Bhéal Feirste, áit a mbeidh fáil ar raon iomlán seirbhísí géarliachta agus seirbhísí tacaíochta diagnóiseacha. Níl aon phleananna agam Ospidéal Pháirc Belvoir a úsáid do sholáthar seirbhísí radaiteiripe ó bheidh an lárionad nua ailse tógtha.
In line with the Campbell Report, radiotherapy services will be provided at the regional cancer centre, which is to be constructed on the Belfast City Hospital site, where a full range of acute and diagnostic support services will be available. I have no plans to use Belvoir Park Hospital for the provision of radiotherapy services once the new cancer centre has been constructed.

Ms Pauline Armitage: I understand what the Minister has said, but I ask her to reconsider. Some £600,000 has been spent on Belvoir Park Hospital already. Friends of Montgomery House have secured funding for a new magnetic resonance imaging (MRI) scanner, and they will take care of the recurring costs. If the Minister were to consider using Belvoir Park, it would be in the Department’s financial interest to keep it simply as a radiotherapy treatment centre. Moreover, given the waiting lists, to do so would take some of the pressure off the new cancer centre, which may or may not be open in 2005. Belvoir Park has a good reputation, and the new cancer centre will take time to develop. Does the Minister agree that that option should be considered, given the amount of money that has already been invested in Belvoir Park and the amount of money that the Friends of Montgomery House are prepared to invest in the hospital? When —

Mr Speaker: Order. This is an opportunity for the Member to ask a supplementary question, which she has done. It is not an opportunity to make a robust case in favour of a particular view.

Ms Pauline Armitage: I would never dream of doing that, Mr Speaker.

Mr Speaker: Order. I call the Minister to respond.

Ms Pauline Armitage: I have not even asked the question.

Mr Speaker: The Member has already asked at least one question.

Ms Bairbre de Brún: The Campbell Report recommended that radiotherapy and chemotherapy services should be moved from Belvoir Park Hospital to Belfast City Hospital and become an integral part of the regional cancer centre. The report recognised that changes in treatment, together with the increasingly elderly population, will require clinicians to deal with people who are likely to be more ill and suffering from complex medical problems. Therefore, the report concluded that radiotherapy and chemotherapy services should be delivered in an acute hospital setting, where there is the full back-up of acute and diagnostic services. The relocation of radiotherapy and chemotherapy services from Belvoir Park to the City Hospital will give acutely ill cancer patients direct on-site access to general and specialist physicians and surgeons. For that reason, those services are better placed at the City Hospital site.

Mr Gerry McHugh: Go raibh maith agat, a Cheann Comhairle. What has been done to keep Belvoir Park Hospital going until the new cancer centre opens? When will the opening date for the centre be announced?

Ms Bairbre de Brún: Pending the opening of the cancer centre, I am determined to ensure that cancer sufferers have the best possible treatment and care. I have made it clear that services at Belvoir Park are an important aspect of cancer treatment and that the hospital has an important and continuing role. I have underpinned current service provision by approving the acquisition of two linear accelerators at a capital cost of £3·8 million. I have also approved an investment of £550,000 for urgent remedial work to the building infrastructure and equipment at Belvoir Park, my officials are urgently considering the case for a replacement CT scanner for the hospital and I expect to announce the way forward soon.
The regional cancer centre is a keystone of the pattern of cancer services that I wish to develop. It is critical that we have a modern state-of-the-art facility, and it is my intention that that becomes a reality as soon as possible. Significant progress has been made on the Belfast City Hospital site. With regard to the cancer centre, I inherited a planned investment of some £32 million and a private finance initiative (PFI) process that had been set in motion by the previous Administration. Last year, the trusts and clinicians involved said that a state-of-the-art facility was needed that incorporated new and emerging technology and that advances made in patient care and treatment must be built on, so I had to decide whether the original proposal was adequate. The trusts and clinicians made the case that the rapid evolution of the concept of a cancer centre meant that the original proposal was no longer adequate. My Department and the Department of Finance and Personnel have now approved the revised business case at a cost of £57 million, and I will make an announcement on that before the summer recess.

Local Health and Social Care Groups

Mr Roy Beggs: 4. asked the Minister of Health, Social Services and Public Safety to detail the total number of additional staff required to run the proposed new local health and social care groups.
(AQO997/01)

Ms Bairbre de Brún: Beidh ar gach grúpa áitiúil sláinte agus cúraim shóisialta, a mbeidh 15 ar fad díobh ann, bainisteoir a cheapadh. Is é is dóiche go gceapfaidh grúpaí ar a laghad comhalta amháin eile d’fhoireann tacaíochta, cé gur faoi na grúpaí iad féin a bheidh sé cinneadh a dhéanamh faoin líon iomlán foirne a bheidh riachtanach. Ar an chuid is lú de, mar sin de, beidh 30 duine nua foirne de dhíth le tacaíocht a sholáthar do na grúpaí áitiúla sláinte agus cúraim shóisialta.
There will be 15 local health and social care groups, all of which will be required to appoint a manager. It is likely that groups will appoint at least one other member of support staff, although the total number of staff required will be a matter for the groups themselves to decide. As a minimum, 30 new staff will be needed to support the local health and social care groups.

Mr Roy Beggs: Does the Minister acknowledge that she already has a sizeable number of administrative staff in her Department, as do the health boards and trusts? Does she further accept that she has created yet another layer of bureaucracy in the Health Service through the creation of local health and social care groups without making significant reductions in other bureaucratic levels in the service? What purpose do health boards serve other than to deflect criticism from her Department? When will the layers of bureaucracy be removed so that money goes to the patients instead?

Ms Bairbre de Brún: The ending of GP fundholding and the creation of local health and social care groups will not only allow local people to take local decisions about local services, it will also allow money to be moved from administration to front-line care. I anticipate that £2·5 million will be freed up and that money that was spent on administration will be spent on front-line care.
The wider structures will be addressed in discussions that the Executive will hold on the proposals and recommendations made in the acute hospitals review group’s report and as part of the review of public administration. The continued existence of boards and trusts, how many there will be, what their functions will be and how other structures will fit in will be addressed in that context.
Whatever emerges, it is important to ensure that the arrangements support the close working of all parts of the health and personal social services and that the interconnection between health and social services, education, housing and other key public services is facilitated.
From the outset, I have ensured that the new local health and social care groups will be set up and operated in such a way as to be flexible enough to be accommodated within any wider structural changes in health and social services that emerge from the planned review of public administration.

Mr Kieran McCarthy: I welcome the Minister’s response to our debate earlier today. Given that the majority of people being asked to serve on these new groups are from the health professions, can the Minister assure the House that these medical people will not be required to carry out clerical or administrative work to the detriment of ordinary patients?

Ms Bairbre de Brún: Compensating people for the time that they give to these boards will allow GPs and pharmacists, for example, to employ locum cover. That will ensure that they are able to carry out this work and that their other work will not suffer as a result. It is not my intention that anybody should be out of pocket because of these arrangements. I have put forward a figure of £3 per head for the management of these groups, and I will keep that under review.

Ms Sue Ramsey: Go raibh maith agat, a Cheann Comhairle. Can the Minister answer the criticism that boards and trusts will dominate the management boards of new local health and social care groups?

Ms Bairbre de Brún: Such fears have been expressed, but they were not borne out by the commissioning pilots, which also have board and trust managements on their boards, and on which the new groups have been based. Board and trust representatives will together fill only six of the 18 places on the management board, and GPs will fill five — so no one group or profession will dominate the new groups. Also, as part of their quota, boards and trusts must nominate a nurse, a social worker and a professional allied to medicine, which means that there will be two nurses, two social workers and two professionals allied to medicine on each group. In that regard, I point out that the generic term "nurses" refers to nurses, midwives and health visitors whose names are on the register of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC).
The management boards of the groups must devise effective mechanisms to ensure the involvement of other stakeholders and members of the wider local health and social care group who are involved at the grass roots. It will be up to the management boards of the new groups to ensure that there is a bottom-up approach. I am confident that the management structure and representation on the boards are such that no group or profession will dominate. We now have a unique opportunity for primary care professionals and others, working at local level with local people, to have a way of ensuring that local people and primary care are at the centre of our health and social services.

Elective Surgery

Mr Paul Berry: 5. asked the Minister of Health, Social Services and Public Safety to outline the total number of elective surgery procedures scheduled to take place in each hospital in 2002.
(AQO962/01)

Ms Bairbre de Brún: Níl fáil ar an eolas atá á lorg san fhoirm ina n-iarrtar é. Ba chóir go mbeadh eolas ar mhéid na ngnáthamh roghnach atá pleanáilte do 2002-2003 ar fáil níos déanaí an mhí seo. Socróidh mé go gcuirfear é sin i Leabharlann an Tionóil agus cuirfidh mé an Comhalta ar an eolas dá réir.
That information is not available in the form requested. Information on the volume of elective episodes planned for 2002-03 should be available later this month. I shall arrange to have that information placed in the Assembly Library, and I will notify the Member accordingly.

Mr Paul Berry: Surely the Minister will recognise again that she has failed — she has not grasped the waiting lists problem in the hospitals and the recent crisis in the Royal Victoria Hospital’s fracture wards. How many elective surgical procedures have been cancelled in all hospitals in Northern Ireland to date?

Ms Bairbre de Brún: The waiting lists question is not one that can be tackled in isolation from the broader pressures on hospital services, which have seen the number of emergency admissions rising steadily over the past year or so. Regarding capacity, the only cure is more resources. We need sustained long-term action, supported by the resources and the service capacity necessary to bring waiting lists down.
On efficiency, there is a significant programme of work under way to improve the flow of patients through the system. That includes reducing the number of people who fail to keep their appointments; putting in place alternatives to hospital admission, such as physiotherapists in the community treating patients with back pain; making sure theatres are operating at maximum capacity; and validating lists to ensure that they are accurate.
In spite of our difficulties, three out of four people get treatment within three months, and 95% of those people are treated within a year. Not all the same people are waiting at the same time. The people on the waiting lists are constantly changing.
I answered several questions recently about the elective procedures that have been cancelled. I refer the Member to those answers, and I will ask officials today what other detailed information they can give to the Member.

Mr Denis Watson: Given the high level of cancellations and the emergency pressure on beds, what measures is the Minister considering to protect beds that can be solely used for elective surgery?

Ms Bairbre de Brún: The service will be asked to increase the level of protected elective capacity during the next year — units that will not be affected by pressures. Altnagelvin Hospital already has a good model in place with doctors performing approximately 1,000 procedures a year. Some of the recommendations in the acute hospitals review group’s report also mentioned that point, so it will be included in the Executive’s discussion about proposals for the way forward in wider acute service provision. As well as that, an extra 1,000 community care places will be available next year, which will help to reduce the number of people in hospital, thus freeing up hospital capacity for operations.

Mr Mick Murphy: Go raibh maith agat, a Cheann Comhairle. What actions is the Minister taking to tackle waiting lists?

Ms Bairbre de Brún: In addition to the points that I have outlined in my answer to the previous Member, 262 patients have been offered the opportunity to have cardiac surgery in Glasgow or elsewhere this year rather than wait for treatment locally. For example, the Northern Health and Social Services Board hopes that 51 patients will be treated in Scotland by the end of March, which would deal with all the board’s excess.
The Royal Group of Hospitals has confirmed that by the end of March doctors there will have completed more than 700 procedures. The Western Health and Social Services Board has held additional ophthalmology clinics at Roe Valley Hospital, reducing the number of waiting inpatients from 360 to 30 and thus reducing the average waiting time from two years to six months.
Ward 8 in the Royal Victoria Hospital has been re- organised as an elective surgery ward for six months of the year and as an emergency admissions ward for the other six months. A mobile magnetic resonance imaging unit was brought in to provide a scanning service to help the Northern and Western boards reduce waiting lists there. Additional scanning capacity from a mobile unit is also available at the Royal Victoria Hospital. Those are some of the specific actions that have been taken to help individual patients — who did not have to wait as long as they otherwise might have had to.
I outlined earlier the type of work that is under way to improve the flow of patients through the system. Of course, with regard to asking and pleading for extra resources, we cannot carry out the work unless the service has the beds, staff, equipment and theatre time. To reduce waiting lists we need sustained long-term action supported by resources and the necessary service capacity.

Waiting Period for Fractures

Mr Edwin Poots: 6. asked the Minister of Health, Social Services and Public Safety to detail (a) the current waiting period for patients requiring treatment for fractures; and (b) how this compares with previous years.
(AQO981/01)

Ms Bairbre de Brún: Glactar formhór na n-othar ag a bhfuil briseadh cnáimhe isteach san ospidéal mar iontrálacha éigeandála, agus déantar iad a chóireáil a luaithe is féidir de réir tosaíochtaí cliniciúla. Bíonn a n-obráid ag formhór na ndaoine a mbaineann máinliacht lena gcóireáil faoi cheann dhá lá. Níl fáil ar eolas comparáideach ó bhlianta roimhe seo.
Most fracture patients are emergency admissions and are treated as soon as possible in accordance with clinical priority. The majority of those operations are carried out within two days.

Mr Edwin Poots: I hear what the Minister is saying, but what is happening on the ground is different. I have heard about people having to wait more than a week to have fractures repaired. We have also heard the Minister complaining today about not having enough resources. People who have to wait for up to two weeks to get fractures repaired are using much needed resources, and that creates a situation in which mismanagement is eating into the funding that we are giving to the health and social services budget, which has been increased by 37%.
Surely the Minister can do more to ensure that patients get treated immediately and do not have to suffer undue pain and suffering and that we do not have the bed blocking that takes place as a result of mismanagement.

Ms Bairbre de Brún: People who sustain fractures are first assessed at an accident and emergency department to determine whether they require surgery at a main fracture centre. If they do, they are transferred to one of the fracture units at the Royal Victoria, the Ulster or Altnagelvin hospitals. I am assured that arrangements are in place to ensure that as far as possible everyone who is assessed as requiring inpatient fracture surgery is transferred to a main fracture centre as soon as possible and within 48 hours at the latest. All patients who are admitted either directly to a main fracture centre or are transferred from a local hospital are clinically assessed at a main fracture centre, and treatment is prioritised accordingly.
It is clearly not acceptable that some people must wait a long time for this treatment. Our fracture services have been under sustained pressure for some time as a result of an increased demand for surgery, coupled with a shortage of specialist staff, such as anaesthetists and orthopaedic surgeons both here and in the NHS. I have outlined the ongoing work. In addition, in planning for the present and the future, my Department has afforded a high priority to training in this speciality. Specifically, the number of trainees in orthopaedics has increased by almost 50% in the past five years, and further increases are planned.

Mr John Kelly: Are pressures on fracture services affecting orthopaedic surgery?

Ms Bairbre de Brún: Yes, unfortunately, our fracture services have been under sustained pressure for some time. Although every effort is made to minimise the impact on other services, the nature of trauma and fracture injuries is such that urgent surgery is often required. Regrettably, that has resulted in the cancellation of some elective orthopaedic surgery.

Primary Care Group Discussions

Mr Alan McFarland: 7. asked the Minister of Health, Social Services and Public Safety what discussions have taken place with GPs, nurses and community care staff in the light of the Department’s proposals for the introduction of primary care groups.
(AQO979/01)

Ms Bairbre de Brún: Tá moltaí ag an Roinn grúpaí cúraim phríomhúil a thabhairt isteach, agus mar sin bhí cruinnithe ag feidhmeannaigh i mo Roinn le gnáthdhochtúirí, altraí, oibrithe sóisialta, cógaiseoirí, boird agus iontaobhais.
In the light of my Department’s proposals to introduce primary care groups, officials in my Department have had meetings with GPs, nurses, social workers, pharmacists, boards and trusts.

Mr Alan McFarland: There is great excitement in the House today, because it looks as if we are going to get past question 7. With questions to the Minister of Health, Social Services and Public Safety, that must be a record.
In spite of the debates this morning and the questions so far, I am still not clear what has gone wrong, given that all the royal colleges and medical professionals are at odds with the Minister’s plan for primary care groups. Will the Minister tell us what has gone wrong with the consultation, or has she decided to take on the royal colleges as a test of strength?

Ms Bairbre de Brún: If anyone is deciding to take on anyone else in a test of strength, the Member may want to look closer to home than to ask the question of me. It is certainly not my intention to do anything of the sort. I have talked to many groups, as has my Department. I detailed in the debate earlier the long programme of consultation and meetings that I have had with groups — as late as today.
Within a week of receiving a letter asking for a meeting with the British Medical Association, the Royal College of Nursing and the Royal College of Midwives, I agreed to meet those groups. The letter arrived on 7 March, and I have said that I will meet them on Wednesday of this week. There is no question but that I have spoken in detail and have sent out detailed guidance. That guidance has also been given to Committee members, some of whom have contradicted what was written in the guidance in television and radio interviews, saying that certain things would not happen when they were clearly written in the guidance.
However, I am attempting, yet again today, to ensure that I address people’s concerns by telling them that the services of the GP fundholders will be maintained until local health and social care groups have had a chance to make their decisions about them. I expect the professional delivery of those services to continue and the £3 per head that I referred to previously to be sufficient for the management costs. I will look at that, and I am prepared to keep it under review.
There will be very few, if any, redundancies, and given the management structure of the groups, no individual profession will dominate them. The arrangements for the new groups are based on the proposals set out in the consultation document ‘Building the Way Forward in Primary Care’, which received widespread support. The configuration of the groups has been announced, and action has been taken by boards to ensure that management boards are established by April.

Macmillan Doctors

Mr Jim Shannon: 8. asked the Minister of Health, Social Services and Public Safety to detail the number of Macmillan doctors currently working in each trust.
(AQO963/01)

Ms Bairbre de Brún: I láthair na huaire, tá naonúr dochtúir Macmillan ag obair in iontaobhais na seirbhísí sláinte agus sóisialta; triúr in Ospidéal Chathair Bhéal Feirste, triúr i nGrúpa Ospidéal Ceantair Craigavon; duine sna hOspidéil Aontaithe, duine in Ospidéal Speirín, Tír na Lochanna agus duine in Ospidéal Ceantair Ailt na nGealbhan.
There are currently nine Macmillan doctors working in health and social services trusts: three in the Belfast City Hospital Trust, three in the Craigavon Area Hospital Group Trust and one each in the United Hospitals Trust, the Sperrin Lakeland Trust and the Altnagelvin Hospitals Trust.

Mr Jim Shannon: Although I welcome the fact that there are nine Macmillan doctors working in the hospitals, will the Minister say what steps will be taken to ensure that the expertise of Macmillan doctors is made available to the other hospitals keen to use it and co-operate directly with Macmillan cancer care? Will the Minister say if any of the Macmillan doctors will be used to treat teenagers in the Royal Victoria Hospital? What steps will be taken to ensure that advantage is taken of that?

Ms Bairbre de Brún: I recognise the significant contribution that charities in the voluntary sector make to providing care for people with cancer. That complements the services provided by the Department of Health, Social Services and Public Safety, particularly in the development of palliative care, and no group does that better than the Macmillan group. I have been honoured to attend several events where I have been able to express my thanks and gratitude for the work they have done — in keeping with opportunities to express the same thanks to other groups. They discuss with local trusts, boards and service users the best way forward and how they can help to complement the other services provided. I expect that that will continue in the same way with the Royal Group of Hospitals Trust as with any other trusts with which Macmillan works. The trusts and boards will be able to discuss the way forward and suggest proposals.

Mr Speaker: Ms McWilliams, Mr McElduff, Mrs E Bell and Mr Gallagher are not in their places.

Discussions on Primary Care

Mr Boyd Douglas: 15. asked the Minister of Health, Social Services and Public Safety what discussion has taken place between her Department and (a) the BMA (NI) General Practitioners’ Committee; (b) the Royal College of Nursing; and (c) the Royal College of Midwives regarding the future of primary care.
(AQO986/01)

Ms Bairbre de Brún: Chuathas i gcomhairle le gach grúpa sa liosta faoi shocruithe sa chúram príomhúil sa todhchaí, agus bhuail mé le Coiste TÉ na nGnáthdhochtúirí de chuid an CMB agus leis an Choláiste Ríoga Altranais lena ndearcadh ar chúram príomhúil sa todhchaí anseo a phlé. Tá mé le casadh leis na trí grúpaí sin le gairid.
All the groups listed were consulted about future arrangements for primary care, and I have met the Northern Ireland general practitioners’ committee of the British Medical Association and the Royal College of Nursing to discuss their views on primary care here. I am due to meet all three again shortly.

Mr Boyd Douglas: Does the Minister think that it is wise to continue with her plans for primary care considering the opposition from those three groups? They represent the majority. What steps will she take to allay their concerns?

Ms Bairbre de Brún: In the debate earlier today on primary care the Chairperson of the Committee for Health, Social Services and Public Safety told me that those organisations are in favour of local health and social care groups. I look forward to discussing that matter with them when we meet on Wednesday. On the question of addressing their concerns, I refer the Member to my answers to previous questions today. I am proceeding because of the level of support expressed during last year’s consultation on the ‘Building the Way Forward in Primary Care’ document.
Recent expressions of support have come from the Association of Directors of Social Services; the advisory committee of the professions allied to medicine; the directors of nursing of the four health boards; the Foyle area nurse practitioners in general practice forum; community practitioners in the Health Visitor’s Association, and Armagh City and District Health and Social Services Community Forum.
I am proceeding because of the success of the commissioning pilots on which the new groups are based and because I want to put more money into front-line services and so that local people and local health professionals can work together in a multidisciplinary fashion to make local decisions about local services.

Finance and Personnel

Mr Speaker: Question 2, in the name of Mr Oliver Gibson, and question 9, in the name of Mr John Dallat, have been withdrawn and will receive written answers.

Public-Private Partnerships: Working Group Report

Mr John Fee: 1. asked the Minister of Finance and Personnel when the report of the public-private partnerships working group will be available to the Assembly.
(AQO1007/01)

Dr Sean Farren: The working group’s report on the use of public-private partnerships is due for completion by the end of March. The Executive will consider the report in early April and will subsequently decide on an early date for publication for public consultation.

Mr John Fee: Public-private partnerships are having an enormous impact on the way in which public services are funded. Will the Minister tell the House what criteria are being used to determine when the public-private partnership mechanism can be used to deliver public services?

Dr Sean Farren: We are gathering considerable experience in the application of public-private partnerships to ensure the delivery of infrastructural developments and public sector services. In that context, it was important to carry out the review that has recently taken place. Whatever options are chosen, it is essential that the use of public-private partnerships to deliver public services, where appropriate, must be affordable, deliver value for money and provide effective solutions that meet the needs of our public services in the public interest. In that sense, the use of public-private partnerships is not ideologically driven. Their use is only one way of dealing with the real needs of our public services. I trust that that summary of the general criteria will indicate the basis upon which public-private partnerships can be used to help meet our objectives with regard to our public services and the infrastructures they require.

Mr Speaker: Question 10, in the name of Mrs Eileen Bell, has been withdrawn.

Accommodation Review

Mr Tommy Gallagher: 3. asked the Minister of Finance and Personnel for an update on the accommodation review.
(AQO1006/01)

Dr Sean Farren: The consultants carrying out the accommodation review on our behalf have identified several competing issues that require policy formulation and direction before detailed option analysis can be carried out.
Our policy decisions would be better framed in the light of comments from all interested parties. I have, therefore, given approval for the Department of Finance and Personnel to issue, for public consultation, an interim report on the accommodation review. That report is available to Members today.

Mr Tommy Gallagher: I welcome the interim report. When will the final report be issued?

Dr Sean Farren: The interim report is being issued today for consultation, and six weeks, up until 19 April, have being granted for public comment. It will take time to come to a view based on the various issues raised in the comments that are received. Therefore it would be reasonable to expect consultants to issue their final report in June.

Mr Ken Robinson: I am especially interested in the Minister’s announcement that the interim report is to be issued today. Does he acknowledge that, in considering the relocation of Civil Service functions, he must consider the cost implications, such as new travel costs, the efficiencies and overall costs for the new Civil Service locations? Will he bear in mind that the contents of his written replies to questions posed by me clearly show that Larne, Carrickfergus and Newtownabbey have a lower percentage of Civil Service jobs than Londonderry, Omagh and Strabane, which lie west of the Bann?

Dr Sean Farren: Issues related to costs will have to be addressed when the recommendations that arise from this important review are being addressed. I am aware, from frequent questions posed in the Assembly, that the review excites much interest across all the constituencies represented here.
The Member highlighted certain council areas. The recommendations must be set in the context of what is feasible and what is appropriate. The Member will have concerns for whatever locations, if any, are to be identified for sections of the public service. The Department will take full account of the facilities that are available, not only in the areas that the Member has drawn to our attention but also in other areas.

Spending Review 2002/Barnett Formula

Dr Joe Hendron: 4. asked the Minister of Finance and Personnel what discussions he has had with HM Treasury regarding the spending review 2002 and the Barnett formula.
(AQO1010/01)

Dr Sean Farren: I have had no direct contact with Treasury Ministers on those issues as the Executive are currently considering the Barnett formula and its relationship with the 2002 spending review. However, my officials are in regular contact to ensure that we are fully engaged in all spending review processes that are under way in the Treasury.

Dr Joe Hendron: There has been much speculation about the Barnett formula. What is the Minister’s position on that?

Dr Sean Farren: When it comes to such matters, it becomes an Executive position rather than a personal position of the Minister of Finance and Personnel or any other Minister. However, Members will accept that now is not the time to state publicly all that we have in mind for the forthcoming negotiations with the Treasury. The Department of Finance and Personnel is determined to seek a fair and appropriate outcome to the 2002 spending review. The case will be pressed at the highest levels.
Public expenditure allocations to, and consequent spending within, Northern Ireland should be based on a fair and objective analysis of our needs. The key issue is the extent to which the Barnett formula addresses that. The Department has undertaken a detailed and rigorous scrutiny of the Barnett formula to examine carefully whether it currently meets our needs sufficiently and, more importantly, whether it will do so in the future. We cannot accept a situation where the provision for priority services such as health, education and transport is markedly less favourable than in England. That appears to be the consequence of the Barnett formula as it is currently interpreted and applied. For that reason the Department has undertaken a rigorous scrutiny of the formula, and our anticipated allocations as they are currently constructed, during the spending review.

Mr George Savage: Can the Minister confirm that there may be risks as well as opportunities related to the review of the Barnett formula? How is he maximising the opportunities and minimising the risks associated with that?

Dr Sean Farren: I made a statement to the House last week on the timetable for the Budget, which included indications of the staging of the process with regard to the spending review. I made the point that it was not a no-risk process to address, in however detailed a manner, the Barnett formula and the outcomes from its application to our spending needs.
The Department has been engaged in a needs and effectiveness evaluation across several Departments in order to test the extent to which current allocations meet the needs of those Departments. The six Departments under evaluation spend approximately 70% of the total public expenditure for which the Department of Finance and Personnel is responsible. Therefore, a good picture will emerge of how well current allocations under the Barnett formula enable us to meet needs and how effectively we use allocations. That is a large task in our preparations to address the Barnett formula with the Treasury and how it will be used to determine our allocations under the current spending review.

Senior Civil Service Review

Mrs Iris Robinson: 5. asked the Minister of Finance and Personnel to make a statement regarding the report he has received from Lord Ouseley concerning the review of appointment and promotion procedures to the senior Civil Service.
(AQO985/01)

Mr Arthur Doherty: 6. asked the Minister of Finance and Personnel to give an update on the progress of the review of the senior Civil Service.
(AQO1005/01)

Dr Sean Farren: I will take questions 5 and 6 together.
The first meeting of the review team took place on Monday 5 March 2001. Since then Members have met regularly to consider and analyse the many complex issues that have arisen. The team has also undertaken a programme of consultation with key stakeholders and other interested parties. That has taken longer than was anticipated at the time the review team was invited to set about its work.
However, the review team has indicated that it will report to me this week. I will then bring the report, with my recommendations, to the Executive for their consideration and final decisions.

Mrs Iris Robinson: In the light of recent media coverage on the issue of age discrimination in the United Kingdom, and following the completion of the review of appointment and promotion procedures for the senior Civil Service, will the Minister confirm that civil servants in the Northern Ireland Civil Service will now be entitled to continue working until they reach the age of 65, instead of the mandatory retirement age of 60, which is currently the case?

Dr Sean Farren: The issue of the retirement age for senior civil servants was included in the review at the request of my predecessor, Mark Durkan. As I am just about to receive the review, I have not had the opportunity to consider what it may recommend about the age of retirement, and so I am not in a position to answer the Member’s question. When the report of the review has been received, that issue, along with others, will be fully addressed. Whether we take the matter forward on its own, or as part of the other recommendations that the review report is likely to contain, remains to be decided upon. However, I can assure the Member that the review team has positively addressed the senior Civil Service retirement age issue.

Mr Arthur Doherty: Can the Minister indicate at this stage how the recommendations contained in the report may be taken forward?

Dr Sean Farren: As Members will be aware, the review was a Programme for Government commitment, and taking forward its recommendations is a commitment in the current Programme for Government. Exactly how they will be taken forward will depend on the nature of the recommendations and any views expressed during the subsequent consultation. Once the way forward is agreed, I anticipate that an action plan will be developed, and the views of the Committee for Finance and Personnel will be taken. I will be monitoring closely the progress on that plan thereafter.

Mr Sam Foster: I thank the Minister for his frankness. In the review of Civil Service staff, which will, no doubt, affect other staff, does the Minister intend to move senior staff in some Departments outside of Belfast? Will he consider the movement of such staff and Departments to Fermanagh where there is currently ideal office accommodation available in the Lisnaskea area? That area has lost many jobs recently.

Dr Sean Farren: The question is allied to an earlier one. I will answer it in the same terms. When and if we come to the relocation of sections of the Civil Service, it will not simply be a matter of relocating members of the senior Civil Service or deciding whether to relocate to County Fermanagh, a county of considerable natural beauty. I am sure that many civil servants would be only too delighted to work and perhaps live there. The qualities of Fermanagh — not just its natural beauty but also the facilities that it can provide — will be fully considered, along with those of the areas that his party Colleague Mr Ken Robinson drew my attention to. He would have described those areas in no less laudatory terms.

Mr Kieran McCarthy: Once again, I am disappointed by the delay. We were supposed to receive a response to the question in July 2001 and then in February 2002. Now we are being told that the Executive will meet, but we do not know when that will happen, or what the outcome will be. Some people have lost out because of the delay, and more people will lose out if decisions are not made quickly. Will there be compensation for those people, and will it be backdated?

Dr Sean Farren: The Member raises an interesting point. In answer to the first part of his question, when reviews are established they are often expected to be completed quickly. However, sometimes that expectation is not realised, because the issues turn out to be complex, and a variety of views must be considered in depth. I have been impressed by the work of the review team under Lord Ouseley, whom I had the pleasure of meeting. He gave me a progress report on the work of the review team several months ago. The complexity of the issues struck me forcibly at that time. It is far better to have a full, comprehensive report that addresses all of the issues, than one that is completed solely to try to meet a deadline. I accept that the deadline was set with the expectation that it would be met. However, we will have a full and comprehensive report.
I fail to understand what lies behind the second part of the Member’s question about compensation. I have not had an opportunity to consider that issue, nor has my attention been drawn to any matter for which compensation might be sought. If, when the review is published, the Member has concerns about compensation relevant to the work of the review that he feels must be addressed, he should draw that to my attention and the attention of the Executive.

Help with Rates Campaign

Mr P J Bradley: 7. asked the Minister of Finance and Personnel how many people can benefit from the Help with Rates campaign.
(AQO1009/01)

Dr Sean Farren: It is difficult to determine how many people can benefit from the Help with Rates campaign. Housing benefit applications received from the Rate Collection Agency show a downward trend. In 1999-2000, for example, the agency received just over 68,000 applications. This year fewer than 60,000 applications have been received. The current Help with Rates campaign was launched in the light of that downward trend, so that owner-occupiers would be fully aware of their entitlement to housing benefit, which is administered by the Rate Collection Agency on their behalf.
Information suggests that approximately 80% of the applications are successful. However, that percentage can vary from year to year because of changing circumstances. The benefit is led by demand. The agency’s Help with Rates awareness campaign seeks to inform homeowners with low incomes that they may be entitled to help with their rates bill. The campaign will therefore increase the uptake of housing benefit.

Mr P J Bradley: I welcome the Minister’s reply and his efforts to promote the awareness campaign. What steps are being taken to ensure that those who apply are entitled to receive housing benefit?

Dr Sean Farren: Considerable assistance is provided through the offices of the Rate Collection Agency to draw the attention of applicants to their entitlement to housing benefit. The offices are there to provide advice about the benefit and to ensure that applicants are provided with all the information necessary to enable them to clearly establish their means. Entitlement to housing benefit is determined on a means basis.

Mr Ivan Davis: In conjunction with helping with rates, when will rural post offices and shops be entitled to receive rates reductions?

Dr Sean Farren: The rural rate relief scheme, for which an equality impact assessment and new targeting social need (TSN) analysis have been carried out, is now being considered by Department of Finance and Personnel officials. I intend to report to the Executive on the way forward on that issue in the coming weeks.

Historic Town Centres: Upkeep of Property

Mr Roy Beggs: 8. asked the Minister of Finance and Personnel what financial incentives are in place, such as rates rebates, to support the ongoing additional costs associated with the upkeep of property in historic town centres.
(AQO1002/01)

Dr Sean Farren: Rates rebates are not available to assist with the additional cost associated with the upkeep of such properties as those identified in the Member’s question. There are no plans to introduce any such form of rates relief.

Mr Roy Beggs: Will the Minister agree that some town centres are in need of urgent reinvigoration? In some towns over 20% of retail property is vacant. A range of policies may be needed to bring that property back into use and for the public to benefit from those rates. Will he consider reviewing the level of rates in order to allow for the additional costs of maintaining buildings and townscapes of historic merit, and for the re-examination of the rating of vacant property that often causes a blight in town centres, in conjunction with a reassessment of the planning restrictions that might also exist?

Dr Sean Farren: The cost of upkeep of all property affects their market rental values and is, therefore, reflected in their net annual value. The new valuation list currently being prepared will come into force on 1 April 2003. It will redistribute the rate burden of non-domestic ratepayers. Broadly speaking, sectors and locations that have fared well since the last revaluation in 1997 should, all things being equal, find a corresponding reduction in rate liability to the extent that any downturn is reflected in current market rental levels.
Members will be aware that a consultation on the review of rating policy is being prepared and will, it is hoped, be launched in the coming weeks. That will afford everyone an opportunity to make submissions and to deliberate on the basis of future rating policy and on whether there are questions relating to reliefs and exemptions that should be addressed.

Value for Money

Mr Edwin Poots: 11. asked the Minister of Finance and Personnel how he ensures that additional funding for allocated Departments provides value for money.
(AQO984/01)

Dr Sean Farren: A range of measures is in place to ensure that resources used by Departments provide value for money. First, all expenditure is subject to scrutiny by the Department of Finance and Personnel’s central finance group in conjunction with the Office of the First Minister and the Deputy First Minister. The Assembly and its Committees also examine expenditure. In addition, the Comptroller and Auditor General provides the Assembly, and the Public Accounts Committee in particular, with reports that identify the extent to which Departments provide value for money from the resources allocated to them.

Mr Edwin Poots: How does that analysis work for the Department of Health, Social Services and Public Safety? Despite a 37% increase in that Department’s spending in the lifetime of this Assembly, waiting lists are higher than ever. How can the Minister account for the £110,000 that was spent on translation services as good value for money, given the current state of the Health Service?

Dr Sean Farren: Some of those questions need to be directed to the relevant Minister. In response to an earlier question, I said that needs are being assessed. The effectiveness of the manner in which allocated resources are being spent is currently being addressed.

Mr Speaker: I must interrupt the Minister while he is in full flow because the time for questions to the Minister is up.
(Mr Deputy Speaker [Mr J Wilson] in the Chair)

Agriculture Industry

Debate resumed on motion:
That this Assembly urges the Minister of Agriculture and Rural Development and the Executive to consider the implementation of measures which will sustain the viability of the agriculture industry in Northern Ireland. — [Mr Savage.]

Mr Gardiner Kane: The fact that this debate is required suggests a lack of feeling, of which farmers are aware, on the part of the Department of Agriculture and Rural Development for Northern Ireland’s agriculture industry. Minister Rodgers claims to understand the difficulties that farmers face and claims to sympathise with them. Sympathy is simply not enough, and practical solutions seem to be a distant prospect. That is why I do not hesitate to support the motion.
Calls for an early retirement scheme are not a new phenomenon. In the difficult past few years, numerous spokespersons on agriculture have called for such a scheme. Many have gone further and added the obvious accompaniment of a fund for new entrants. The reasons for that are obvious to everyone except the Department of Agriculture and Rural Development.
As the average age of a farmer is 57, and only 7% of farmers are aged under 30, it does not take an enormous stretch of the imagination to make an informed guess on where farming is going — the Province’s primary industry is heading for extinction unless we attract young people back into the business. That can only be done by instilling confidence in young people that there is a future in farming.
The chances are that an 18-year-old with the opportunity to take any kind of job outside farming will do so. Banks will not assist young people, and the Department is indifferent to the plight of young people who wish to carry on, let alone develop, a family business. We must pave the way for the older generation of farmers to retire to make way for young people, who must be given the resources to become involved in farming.
We hear so much about the size of farms. There is no better way to increase the unit size of a farm than to introduce an early retirement scheme alongside a new entrants scheme. To decide that such schemes would not constitute value for money is a short-term view of the situation, and one that I suspect is based on a study that is distinct from the circumstances in Northern Ireland.
I ask the Minister of Agriculture and Rural Development to consider carefully the options for funding such schemes, if she has not already done so. So much is made of the impending increase in membership of the European Union, the effects of globalisation on commodity prices for farm produce and the strategic purchase of produce by processors in the Province that the chance for farmers to succeed appears negligible. Unless all possible action is taken, our industry will not have a sporting chance of success. It will be doomed from the outset.
If given a reasonable chance, Northern Ireland’s farmers can respond to the challenge. The beef export embargoes of the last seven years have proved their resolve. The Department and the Government must serve the farming industry by shaking off a negative and defeatist mentality and setting about the proactive development of a recovery strategy.
I support the motion.

Mr Gerry McHugh: Go raibh maith agat, a LeasCheann Comhairle. I welcome this debate. There have been several debates on agriculture in the Assembly, and those with no particular interest in agriculture will say that this is more of the same. However, the industry needs support, together with a great deal of thought and discussion. The debate on the future, or the extinction, of agriculture is, therefore, timely and vital, and I have no difficulty in supporting the motion.
The difficulty is in trying to find either a retirement scheme or a mixed retirement and loans system, as has been suggested. I have some concern about the use of loans. There is a place for a capital grant scheme to encourage young people into farming. On examining the South’s attempt at a retirement scheme, we find that almost half of the applications came from larger farms and not from the targeted group who would have benefited from the scheme. It did little for the restructuring of farming and for making a difference to the industry by bringing people into it. Will such a scheme make a difference here? All those things must be taken on board.
The Department of Agriculture and Rural Development’s vision document says that there will always be farmers and farming. That is debatable. There may be neither if the current situation is not resolved. Young people are not coming into the industry. They look at their peers and see that they will be economically much better off in one of the many jobs now available, such as construction work. Those factors come into the equation. People do not stay in farming, and older farmers have no extra help. High employment levels and the money available outside farming work against keeping the agriculture industry at its former standard. There have been changes in the last five years. The industry has been damaged by BSE and other food scares.
Sustainable agriculture should be about meeting current needs without compromising the ability of future generations to meet theirs. Social and economic sustainability within the rural community could be another way to look at the matter. Perhaps we should pay farmers for jobs other than food production, such as looking after the countryside. If we have only large farms, will the rural areas be properly taken care of? Will people from the lowlands, for example, be prepared to farm in severely disadvantaged areas? I do not believe that they will. Only people who come from such areas will be prepared to live and work in them, so the idea of changing structures to such an extent will probably not work.
Returns on farming are critical. If milk production does not wash its own face, it will fail, as did small- scale pig production in places such as Fermanagh several years ago. When those farms’ inputs became greater than their returns, they were closed down. There is a possibility that that will happen to all elements of agriculture over the next few years. If we do not do something, there will no be farms here, and we will have to import everything.
The farming infrastructure is critical. Farming has been decimated; it is in decline; and there is waste. Farmers face environmental demands, and they are also under pressure to retrain and get different skills. Furthermore, animal welfare concerns must be incorporated into farming. The Government do not provide support or capital for farmers to deal with any of those pressures. It is very expensive to maintain the infrastructure of a farm, and that must be dealt with or everyone will leave farming, and that is the last thing that we want to happen.
Reform of the common agricultural policy (CAP) is on the top of everyone’s agenda with regard to the direction of policies and world demands. Grassland has been expanded in places such as Brazil and Argentina to create beef production methods. The environmental impact of that is immense. In places such as Argentina, 30% of the gross domestic product (GDP) was beef production or agriculture. However, such countries still went bankrupt. They based their outputs on the lowest sourcing and the lowest labour costs, but it did not work. Is that the direction that we should be taking? Those countries were able to work with cheap resources, such as cheaper pesticides — which they used a great deal of — and had very little or no concern for animal welfare.
There is a growing worldwide demand for food. International trade has been liberalised, and there has been EU enlargement. The notion that expanded globalisation is sustainable is nonsense. Some 13% of all air freight is food. Food, including vegetables and fruit, such as strawberries, is the largest category of air freight. A kilogram of apples has been known to produce at least its own weight in fuel emissions. What is the cost to the world, and to farming on a global scale, of the removal of rainforests to create grassland? That is happening in countries where the greatest benefit is to be had from maintaining the original environment. The demand for low-cost food, at the lowest possible prices, benefits only multinational giants. That situation cannot be sustained. We need a more localised market, which is where organic farming comes into its own. I note that the German Federal Minister of Consumer Protection, Food and Agriculture supports organic farming methods and wants more money to be invested in them. Farming and the environment have to be taken as a whole.

Mr Kieran McCarthy: I welcome the Minister’s presence today. I hope that she has a good pen because I have several questions that I would like her to answer.
I am not a member of the Committee for Agriculture and Rural Development. My leader David Ford has that onerous task, and he apologises that he cannot be present to contribute to the debate. However, as a representative from a constituency with a large farming community, I am only too aware that agriculture is in decline and has been for years.
Some years ago I was a member of the Agriculture Committee in the Northern Ireland Forum for Political Dialogue. I gained some insight into the industry’s problems through visits to the Forum from representatives from every sector in the industry. Unfortunately, the situation has gone downhill since then. We must act now to generate a viable agriculture industry for Northern Ireland before it is too late.
The timing of the motion is somewhat premature, given that a statement may be pending from the Minister in response to the Department’s vision group’s report. Surely it would have been more productive to have waited for the Minister’s formal response and any unique proposals or suggestions that she may have. Perhaps the Minister will give some indication of her thinking in her response. I pay credit to Ms Rodgers. As Minister of Agriculture and Rural Development, she was thrown in at the deep end. She has represented Northern Ireland well not only in agriculture but also in her other duties, including the fishing industry, despite being constrained by European legislation.
I will highlight some specific issues that the Alliance Party hopes to hear more about in the Minister’s response. The Alliance Party shares the desire to have a dynamic, long-term and prosperous future for Northern Ireland’s agrifood sector. Of particular interest are: the need to protect and enhance animal health status; the strengthening of the rural economy through all farming activities, including those that involve beef, crops, milk and so on; and the safeguarding of our land-based heritage and rural developments.
I draw the Minister’s attention to the anxiety of farmers and landowners in the Strangford constituency. The Department of the Environment has designated the coastline of the outer Ards Peninsula and the east coast of the Irish Sea as areas of special scientific interest (ASSIs). Farmers and landowners regard that as a removal of their long-held and long-enjoyed rights, an additional worry that farmers could well do without. Perhaps the Minister’s response will give some relief to those landowners and farmers.
Members referred to an early retirement scheme that could be offered to those who have served the agriculture industry well over the years, and who choose, at this stage, to hang up their wellington boots. Members also referred to the development of an early entrants scheme that would allow young farmers to become involved in the industry in the hope that they would enjoy a good, prosperous future.
I look forward to hearing the Minister address the vision group’s findings that a climate of mistrust and hostility exists in parts of the food chain. There appears to be a lack of synergy among producers, processors and retailers. I would like to know to what degree the Minister endorses the recommendation of the vision group’s report on that.
The recent arrival of multinationals in Northern Ireland has had a detrimental effect on our local food producers and has resulted in an enormous change in demand. Furthermore, Europe’s dictation of food specification — size, shape, colour and so on — has had a huge impact on producers, has placed enormous stress and strain on all local producers and has caused many farmers to pack it in altogether.
Obviously, protecting and enhancing our animal health status is of the utmost importance, and, in this regard, I am sure that the Minister agrees that we need to place urgent priority on tackling brucellosis and tuberculosis.
With regard to strengthening the rural economy, the Alliance Party would emphasise the whole rural economy, which extends beyond agriculture to include non-farming activities, and I am sure that the Minister will agree. Specifically, the vision group’s report recommends the establishment of a rural baseline as a rural proofing benchmark, and that is much needed — indeed, it is overdue.
Among the group’s other recommendations aimed at safeguarding our land-based heritage and rural environment are the promotion and development of good farming practice throughout Northern Ireland and the implementation of the recommendations of our biodiversity strategy. I understand that both those actions require grant aid to be successful. Will the Minister commit adequate financial resources to realise these objectives?
Every person in Northern Ireland has a duty to support local agriculture. Our slogan should be "Buy the good Northern Irish products". Not only would that help to produce the best food and products, it would also help the industry remain one of our major employers. Although we all wish to support agriculture, it is certainly disappointing when the antics of some people in Ballymena threaten the whole industry because some people wish to use a few hours on a Sunday afternoon to promote their good work. Obstacles do not support proclamations of 100% support for agriculture, and 100% support should mean exactly that.
I acknowledge that the Minister has yet to make her formal reply to the vision group’s report, but I look forward to her addressing the matters I have raised. Will the Minister assure me that she will incorporate my party’s specific concerns in her formal reply to the report?
Northern Ireland has lots of capacity to produce good quality food, and in view of the enormous number of people in our world who are starving today, it would be remiss of me not to ask why someone in authority cannot come up with some way of using all our land to produce food and have it despatched to those areas where people are starving to death? The Western World could do more to feed the starving. I support the motion.

Mr Boyd Douglas: I thank Mr Savage for bringing this motion to the Floor today. The agriculture industry has been in a state of flux over the past few years — indeed, since BSE reared its ugly head in 1996. Since then we have had price cuts in all commodities, and with Northern Ireland’s industry being mainly grass-based, these cuts have been most severe with beef, sheep and milk.
I know that the Minister is considering the findings of the vision group’s report and that she hopes to report soon on the measures she wishes to take forward. I have some difficulties with this, as there will not be enough finance to take forward all that she would like to take forward. My fear is that much more finance is needed than will be there.
I do not want to be seen as not supporting the retirement scheme, which other Members have raised, but the finance required will not be forthcoming. What is needed is more assistance for people who want to remain in, or enter, the industry. In my reply to the vision document consultation I asked for a new entrants scheme to create a larger proportion of farmers under the age of 45. This could be managed in conjunction with a low-cost loan system to enable younger farmers to acquire land or expand their business base. Also, there would be merit in awarding higher rates of grant to young farmers for repairs and environmental schemes.
Modulation money, which is increasing this year, could be used to fund this on a Northern Ireland basis. Rationalisation in the farming sector — as has happened over the years — is inevitable, whether we like it or not, so we must ensure adequate advisory and financial support so that new and existing farmers can remain viable in an ever more competitive environment.
We must not forget that if farmers were not caring for the countryside we would not see that patchwork quilt when coming back on a plane. We would have an unkept jungle, which would please the eyes of few, and we would have to rely on foreign food. I agree with Graham Wynn, chief executive of the Royal Society for the Protection of Birds (RSPB), who said at a recent conference that farming should become part of the solution for environmental improvements and not be an environmental problem.
Northern Ireland has a very good environmentally sensitive areas scheme, and there has been a very good uptake by farmers. However, it has been a victim of its own success. Although the main scheme has progressed, and farmers continue to be paid for various measures, the enhancement plan element of the scheme has been shut since 1 April 1999 because of insufficient funds to meet demand. At one time the Department lauded the scheme as the jewel in the crown.
This enhancement plan element provided farmers with more than just money to carry out environmental improvements. It also provided off-farm employment for farmers with small farms. They could develop small businesses to assist the environmental services. In my constituency the scheme provided a boost to off-farm income and made the area more attractive to tourists, thus providing another stream of income. As the scheme is partly funded by the European Commission, Northern Ireland receives additional money. I again call on the Minister to reinstate a proper financially managed scheme as soon as possible, because the Department’s lack of financial management caused the closure.
We also need a scheme to upgrade existing slurry and effluent facilities on farms. Money for this should come from the Department of Agriculture and Rural Development and the Department of the Environment, because they jointly police environmental issues.
A can of worms could be opened in the light of the Department of the Environment’s revisiting the issue of nitrate-vulnerable zones. I agree with the president of the Ulster Farmers’ Union, who said at the weekend in ‘Farming Life’ that any new zones must be based on science alone. If we are to have further restrictions on the disposal of farm waste and effluent, there must be a grant to allow farmers to upgrade as necessary. No farmer wants to see pollution, but if repairs or the expansion necessary to meet proposed measurements cannot be funded, production must cease, and that is precisely what we do not want.
A Member who spoke earlier mentioned farmers hanging up their boots. A farmer never hangs up his boots, but he needs a reasonable return to survive and protect the environment. I am not sure that I agree with Mr McCarthy’s statement about Ballymena. I am opposed to that. Good work is done on Sunday, so I cannot agree with Mr McCarthy’s sentiments.
"Six days shalt thou labour, and do all".
I conclude by calling on the Minister to press Margaret Beckett hard to claim the final tranche of agrimoney compensation from the EU, which could be given to farmers. Although it is only a small amount, it is, nevertheless, a significant amount to individual farmers, and they are entitled to the money. If the British Government had paid UK farmers all the agrimoney compensation that they were entitled to in recent years, the industry would be in a better position to compete on a level playing field. I urge the Minister to use every opportunity in the next weeks to lobby for this compensation. I support the motion.

Dr Esmond Birnie: I congratulate my Colleague, George Savage, for moving the motion on making farming and the food industry more economically sustainable.
Agriculture and the various stages of food processing represent around one tenth of regional gross domestic product (GDP). According to some definitions, it is clearly our most important economic sector. Given that, it is appropriate for those of us who do not represent agricultural constituencies to comment on the motion.
I support George Savage, especially on the early retirement proposals. There are no easy solutions. The right policy for agriculture demands recognition of the external factors that bear down on the Minister of Agriculture and Rural Development and her counterparts in Edinburgh, Cardiff, London and Dublin.
The first external factor is that the common agricultural policy (CAP) cannot remain in its present form. That now seems to be universally accepted. It still takes up half of the European Commission’s budget. The European Union is about to be enlarged, which, in itself, is a good thing. The levels of GDP per head in the countries concerned are around one quarter of our own. Farming accounts for around one tenth to one fifth of their total labour forces, compared to roughly 5% here. Clearly, the CAP in its current form cannot simply be extended to central and eastern Europe.
Since the founding of the European Economic Community in 1957, the CAP has operated by keeping European consumer food prices — the prices that we all pay when we go into the shops to buy food — well above world levels. It has become obvious to commentators across Europe that that is not a cost-effective way of maintaining rural incomes, nor is it now sustainable. It also goes against the historic approach to food policy in the United Kingdom. For example, from the end of the Corn Laws in the 1840s through to the Great Depression of the 1930s, the UK had a policy of free trade and cheap food.
That was then followed, from the second world war to accession to the Common Market in 1973, by the so-called deficiency payment system. This system was able to deliver farming support in a more cost-effective manner than the common agricultural policy. It may well be that in the future as the CAP is dismantled, elements of a deficiency-based system may have to be, and should be, restored.
The second external factor under which the Minister of Agriculture and Rural Development operates is the gradual move to global free trade in farm products. Slowly, but probably irreversibly, the three main world trade blocs in farming — the United States, Japan and the European Union — are beginning to reduce their heavy subsidisation of consumer agricultural prices. That is a good thing to the extent that the way that agriculture has been supported in the rich economies has often acted to the detriment of the poorer countries, notably in Africa.
Annual aid to the Third World from the so-called northern economies amounts to around $50 billion. However, the current level of total agricultural support in Japan, the EU and the United States amounts to six or seven times that — $350 billion a year. That is a strange imbalance, and Mr McCarthy rightly referred to global hunger. If the ongoing Doha World Trade Organisation round is successful in freeing up food and textile trade, that could increase the total GDP of the world’s poorer countries by around $1,500 billion — $1·5 trillion — by 2015 and lift an extra 320 million people out of dire poverty. Clearly, that is desirable.
In summary, we must move to a more diversified and self-sustaining economy in our rural areas. That is the implication of the global constraints under which agriculture here operates. That would be to the good of all in Northern Ireland, and it would also benefit the poorer parts of the world, whether that be Poland and Hungary in central and eastern Europe or various parts of Africa.
Mr Savage’s motion points in the right direction. The House of Commons Agriculture Committee is studying farming policy in various countries, most notably New Zealand, where a radical approach has been taken over the past two decades.
We cannot be like Canute. The tide is moving against the farming policy that operated in the 1970s and 1980s, and we cannot go back to that. I support the motion and its innovative ideas.

Mr Eddie McGrady: It is with some trepidation that I follow the erudition of Dr Birnie on the macroeconomics of farming and the global track on which he led us. It was a fascinating and interesting trip. However, he distilled the whole subject when he said that we must achieve a recovery for the farming community and achieve sustainable viability in farming. I think that was the crux of his message.
I have some difficulty in speaking to this motion because it urges the Minister of Agriculture and Rural Development to do something. The Minister does not require urging; she has been in a very urgent mode since the outbreak of foot-and-mouth disease. However, a motion asking us to consider implementation measures for sustaining viability should have had more examples of what Mr Savage wants the House, the Department and the Executive to do. Many Members took their cause, or their exercise as we said at school, from the ‘Vision for the Future of the Agri-food Industry’. I could easily list headings from the Executive summary, but that would add nothing to the debate.
Dr Birnie said that the gross domestic produce (GDP) of agriculture is one tenth of the economic contribution in Northern Ireland. In my constituency, as in others, it is much greater. Our rural community depends on the viability and profitability of the farming industry, and we require a radical view. I was pleased when I read the ‘Vision for the Future of the Agri-food Industry’ and even more pleased with the response from the Ulster Farmers’ Union. The recommendations scored 99 out of 100; it is no mean achievement for representatives of the farming community to agree 99% with the Department of Agriculture and Rural Development. That gives us a blueprint for progress.
I can only emphasise one or two aspects of the problems we face in the aftermath of BSE and of foot-and-mouth disease. One obvious and uncontroversial objective should be to improve the control of animal disease and traceability along with the introduction of disease insurance. These require an all-Ireland mechanism and the concentration of both Governments. It is unfortunate that the irrational outburst of the leader of the UUP may make that more difficult, and that would be to the detriment of the farming industry. I hope that the common sense that prevails in the farming community will prevail in politics and will enable us to continue to address those all-Ireland requirements to sustain our farming and livestock.
There has been an enormous increase in bovine tuberculosis in many constituencies. I have mentioned that disease many times and urge the Minister to address the problem. I also want to emphasise the need for a review of the food chain concept to investigate the direction of profitability from producer to consumer. One or two studies have found the supermarkets "not guilty". I would rather employ the Scottish legal phrase "not proven". That should be looked at again.
The concept of less favoured areas, of which my constituency has a considerable proportion, should be allowed to continue with increased or modernised funding and the maintenance of the 90% safety net for at least another year.
We have all spoken of the need to restructure the farming industry. I am pleased to see that the schemes that we have discussed in the House are well articulated in the vision document, which was published by the Department and endorsed by the Ulster Farmers’ Union. The most important of those schemes is the agricultural restructuring scheme. Its aim is to restructure those aspects of farming that were not delivering viability, profitability and sustainability.
I am also an enthusiastic supporter of the land management contract scheme. I know that it is a difficult scheme, but it looks at farming in its entirety — agricultural production, the custodial relationship of the farmer to the environment and the social requirement to sustain a rural community. Those three things can best be achieved by a broad land management contract scheme.
The other aspect of modernisation is education and training. Our farming sector needs easy access to modern information, techniques and scientific interests. A one-stop shop is needed to facilitate a community that, at its grass roots, is not given to innovation. It must look again, as Dr Birnie said, at what the market requires. We have to move away from the European Union policy of rewarding quantity to a policy that rewards quality. I spoke to a farmer recently who deplored the fact that good quality strains of animals, be they beef or sheep, were rapidly disappearing from our countryside and needed to be sustained by paying for quality and not quantity.
It would be interesting if all the parties in the House could adopt a unanimous approach to the issue. They should publish their responses to the vision document so that we all can read them. The fact that the consultation period ended some weeks ago does not indicate a lack of urgency. With that simple caveat, I support the motion on the clear understanding that "diversity", "profitability" and "sustainability" are the key words.

Mr Edwin Poots: Nobody should have a problem with supporting the motion. If the Minister were not doing what it says in the motion she would have no position to fill. The agriculture industry needs significant support and some rational and innovative thinking to get out of its current situation.
It is regrettable that those issues arise time and again, and many of the same issues are repeated because of the nature of the problems in agriculture.
One of the worst affected areas is the dairy industry, which, up until now, has got away lightly compared with the beef, sheep and pig sectors. The dairy industry has been one of the hardest hit, with milk prices at around 16p per litre. That price cannot be sustained, and dairy farmers cannot withstand it for any length of time. One of the main problems for the dairy industry is debt levels. Beef and sheep farmers could not borrow large amounts of money from the bank, unless they were large operations. However, dairy farmers had the additional collateral of milk quota. Therefore banks allowed many dairy farmers to borrow six-figure sums. They anticipated that the situation would remain good for a considerable time. Unfortunately the most recent downturn has created a situation in which that is not the case. Dairy farming is in a predicament, and many people have a high level of debt. It cannot meet that debt if that situation continues.
I ask the Minister to consider cereal farming, which, in the past three or four years, has been going through a difficult period. The Ulster Farmers’ Union has put forward sensible suggestions on arable aid payments and on how a deal can be done with the rest of the United Kingdom. The suggestion is that there would be a degree of land exchange that would allow Northern Ireland cereal farmers to receive a higher level of payment for arable aid. Such a scenario would not necessarily take away from the aid that is received in the rest of the United Kingdom. I ask the Minister to pursue that further.
I have not heard much noise from the Department on what is being done to improve arable aid payments that are made to Northern Ireland farmers. I want more of the modulation money to come back to the farming community. I know that that money is destined for the rural community, but the money comes out of the pockets of the farming community in the first place. I want more of that money to go back into the pockets of the farmers for environmental schemes, for schemes that improve marketing and for schemes that improve animal health beyond the statutory limits that are set down by the Department.
I welcome the setting up of a group in my constituency called Laganside Rural Development Ltd. It will seek to acquire funding for items of that nature. I hope that the Department of Agriculture and Rural Development will give the group its full support. I welcome the support that has been received from the Department thus far, and we look forward to the support continuing when it comes to the funding of the group.
I have always been on at the Minister about the beef ban. The Department hopes to have the beef ban lifted this year, and it is essential that we get it right and win this time. People’s expectations have been raised that the beef ban would be lifted, but their hopes have been dashed. No one would have thought six or seven years ago that a beef ban would still be in place in 2002. That would have been the worst-case scenario that could have been painted at the time, yet the beef ban remains in place. The Department of Agriculture and Rural Development must put all its efforts into seeking the removal of the ban, and farmers must fully support the Department in its delivery. It is essential that farmers play their part.
Brucellosis is one of the major problems in agriculture. It is anticipated that as many as 3,000 cows could be lost in a small area close to Lagan Valley. That causes us grave concern because some of our top dairy herds are being lost.
We hear much about the benefits of looking after the environment. However, these cattle are dying close to Lagan Valley Regional Park, and I am genuinely concerned that badgers in the park are spreading brucellosis. This costs the Exchequer a great deal of money; it causes considerable hardship to the people involved and causes the death and destruction of many valuable dairy cows. One must consider the benefits of the badgers and the benefits of the businesses that are being lost and weigh them in the balance. In that case, the balance would be heavily on the side of agriculture.
Mr Savage should encourage the Minister of the Environment, Mr Nesbitt, to support the agriculture industry. On Thursday his officials met the Committee for the Environment to discuss farm waste, and the officials gave a poor performance. They sought evidence from the farming community to change legislation; however, the evidence was not convincing for some of the legislation they wanted to introduce. The Department of the Environment cannot operate double standards on this issue. If it wants to introduce legislation, let it produce convincing evidence to support its proposals.
Farmers are concerned about the Minister of the Environment’s second announcement on nitrate-vulnerable zones. They are concerned that if we go down this route, farmers will be crucified. Farmers are often told to do this or do that for the environment, and that is fair enough. However, what support do they receive to carry this out? It is essential that farmers receive the necessary support from the Department of the Environment if they are to carry out its requests.

Mr Mick Murphy: Go raibh maith agat, a LeasCheann Comhairle. I thank Mr Savage for moving the motion, and I should also like to support him in his early retirement scheme. If not that scheme, then some form of grant should be introduced to encourage young people to take up farming; good, strong education and training would also help. Mr Douglas mentioned low-cost loans. I do not support these as the farmer is under enough pressure without having to pay back loans. However, I fully support the early retirement scheme.
I welcome the many actions and recommendations in the ‘Vision for the Future of the Agri-food Industry’. However, there are challenges to be faced in bringing together producers, processors and retailers to ensure that all sections of the production line receive a fair return for profit. The actions and recommendations on strengthening the food chain, protecting our animal health status, developing people and safeguarding heritage and environment are all worthwhile. The challenge for the Department of Agriculture and Rural Development lies in achieving the part of the vision report that states:
"It will act as the guardian of our land-based heritage and rural environment and will help underpin and sustain the social fabric of rural areas."
The number of people involved in farming continues to decline. Young people fail to enter the industry, as it is regarded as low status, and there are better paid jobs available outside farming. The British Government’s policies as well as Europe’s red tape are drawing farmers out of the industry.
Present policies work against the interests of the farmer in the North’s changing economic environment. Factors such as the euro/sterling exchange rate, BSE, the common agricultural policy (CAP) reform and the World Trade Organisation are stated as reasons for decline.
The foot-and-mouth-disease outbreak continues to pose a significant threat and has highlighted the vulnerability of the industry. That outbreak has served to divert attention from the long-term issues that affect the industry. It is vital that that focus returns to them as soon as possible.
The Minister should apply her approach and should identify the problems and opportunities in the rural economy over the next decade. She should develop the ‘Vision for the Future of the Agri-food Industry’ to map out a proper strategy. There is mistrust and hostility throughout the food chain, as producers, processors and retailers do not operate as a sympathetic supply chain but work against one another. They are working to a narrow agenda, within the constraints of British Government policy, following globalisation trends and policies of large-scale production at world prices. That policy will not be sustainable economically or environmentally in this part of the island.
If we are to take seriously the problems facing the farming industry, and if we are to sustain the viability of agriculture, we must work together on an all-Ireland policy, producing a quality product, North and South.
We must remember that farmers have been the backbone of this nation, North and South. It is right that we support them by tackling the issues so that we can become a major player in the world market, providing a strong, healthy product. Go raibh maith agat.

Mr Billy Armstrong: Our farmers are the custodians of the countryside; they have looked after and maintained our land for hundreds of years. Their work has been taken for granted by those who visit the countryside at weekends or during the summer.
After the second world war, we were encouraged to supply an excess of products to support other European countries that were unable to maintain their own people. Northern Ireland now has to compete against these EU countries for markets for our products.
Under direct rule in Northern Ireland no one made specific plans for our health, education or agriculture. It is only since the formation of the Assembly and since our present Minister of Agriculture and Rural Development took up her post that better decisions are being made to improve the situation for the Northern Ireland agriculture industry.
Our farmers need relevant guidance, and a 10-year agriculture plan is essential. Farmers have always been at the mercy of the buyer to provide products at the lowest cost possible. However, they continue to try to realise a moderate income for their family. Profits are at an all-time low, and our farming families are suffering. Over 60,000 people worked on our farms in 1999-2000. That includes 32,000 full-time job equivalents, 90% of which are provided by family members. That shows how families have been dependent on a decreasing farming income.
Farming is no longer an appealing industry in which to be involved. There is no encouragement for the younger generation. The family farm — a heritage that we are proud of — will soon be a thing of the past.
Recently farmers have had the highest rate of suicide of any occupational group in Britain. Farmers do not benefit from a 35-hour week, nor do they get a minimum wage. The industry has long been neglected from protective legislation, but not by red tape and bureaucracy. Farmers have been exploited for the gain of supermarkets and other organisations.
Many farmers plough through tough times in anticipation of a bright future. It is only through the Assembly and the commitment of the Executive and the Minister of Agriculture and Rural Development that the industry can move forward with any optimism. Our agriculture industry requires a major regeneration scheme. As Mr Savage mentioned, ways must be found to encourage young farmers to remain in the industry, so that mature farmers can retire knowing that agriculture will survive.
Thanks to the work of agricultural colleges, young people with enthusiasm and new ideas wait on the sidelines, but there is no incentive for them to go into agriculture, because of low profit margins and an average wage of around £7,000 a year.
Diseases that were unknown here before we joined the EEC — not least the latest epidemic of foot-and-mouth disease — have endangered the health of our animals. If the industry is to survive, more emphasis must be placed on support for farmers with regard to environmental issues. Our farmers are conscious of the environment, and the Government must ensure a reduction in the red tape and bureaucracy and an increase in rural development funding for major capital grants schemes to support biodiversity and address source pollution. That will help us further key environmental objectives.
The development of a sustainable energy system, such as biogas and the use of anaerobic digesters, must be pursued. The creation of model farms in highly productive areas would be one way of achieving that. The Minister of Agriculture and Rural Development must work with the Minister of Enterprise, Trade and Investment and the Minister of the Environment to promote the means of converting waste products into heat and power, so that the majority of waste is no longer an unwanted and unusable surplus but a valuable component vital to the production of energy.
I urge the Minister to recognise that farmers produce good, wholesome, healthy food and, in doing so, they are the custodians of the countryside. With that in mind, she must encourage agriculture to make it a profitable and sustainable industry, which will attract young professionals.

Mr Jim Shannon: I support the motion. I would like to make some quick points, because I realise that time is limited.
It is time that the Department used its imagination to create innovative ideas and examine positive methods to help the ailing farming sector. We are familiar with the catalogue of ills suffered by the industry in recent years. In particular, the problems of the last six years have contributed to the hardest times that I can remember. Farmers have had to deal with BSE, foot-and-mouth disease, supermarket changes, competition and the difference in the exchange rate between the pound and the punt, to name but a few of the problems.
Those matters have combined to effect a downturn in the profitability of every holding in the Province. They have resulted in people moving from the countryside into the towns. There has been a dramatic change in the countryside. I live on a farm on the Ards Peninsula, so I have some idea of what that means. For example, there is one remaining pig farm on the Ards Peninsula — there used to be about a dozen.
The poultry industry has been decimated. Those who were involved in the poultry industry on the Ards Peninsula have abandoned it. There have been dramatic changes in every sector, such as beef, sheep, cereals, and, as Mr Poots said, dairy products.
The industry’s confidence has been knocked, and the future looks bleak for many people. The Department must take stock of changes in the rural community. At the weekend, I read in one of the newspapers that a tourism course for farmers has been advertised on the Scottish Agricultural College’s web site. The Department must develop imaginative initiatives to promote tourism as an alternative to farming. It must provide incentives and help with planning regulations and allow diversification and the advertising of countryside holidays.
All such initiatives would help. However, only so many people can take advantage of such opportunities. EU Directives on setting aside land and retaining the countryside will encourage them to do so.
The Assembly must ensure that finance is available for farmers and landowners. Many need to make their farms more viable, and one way of doing that is to set land aside. It may not be worked, but farmers get an allowance for ensuring that that happens. That should be encouraged, through financial or other means. Advantages and incentives have been slow to come, and that has resulted in land being lost at a crucial time.
Another worrying issue is the drifting away from farms of the sons and daughters of landowners. I refer to the previous point about planning regulations. That cannot be allowed to continue. More flexible planning regulations are needed. I am aware that that is not the direct responsibility of the Minister of Agriculture and Rural Development. However, her Department could make some overtures to the Department of the Environment and to Dermot Nesbitt.
Those who are born on farms and live at home with their parents may want to move on when they get married. In this difficult economic climate it is important that changes be made to enable them to stay on the land. There have been changes in the methods of farming. Many people are now part-time farmers who supplement their incomes through jobs in towns and elsewhere. The regulations must be changed to ensure that sons and daughters — those who want to stay on the land — can farm part-time and also earn income elsewhere. Flexibility is needed, or the rural community will become a desert, a wasteland with few people. That must not be allowed to happen.
I want to make a final point about supermarket chains and the prices that are paid to farmers. I was astounded when I heard last week that a supermarket chain was claiming that it gave fair and equitable prices to farmers for their products. That is not what I have been told by farmers who are unhappy with the prices being paid, which do not reflect the hours that they work or the high-quality goods that they produce.

Rev William McCrea: Does my hon Friend agree that there needs to be a level playing field with the rest of Europe? Northern Ireland’s farmers are made to comply with welfare standards and so on that are set by Europe, but other European countries do not seem to adhere to the same standards. That is a financial burden on our farmers.

Mr Jim Shannon: The Assembly wants Northern Ireland’s farmers to get fair play, but that is not happening. I thank the Member for his comments and ask the Minister to take those points on board.

Ms Brid Rodgers: The motion calls on me to consider the implementation of measures to sustain the viability of the agriculture industry in Northern Ireland. Members are aware of the many problems that have beset the industry in recent years and the impact that those have had on farmers, their families and the rural community.
Almost without exception, those problems have stemmed from events beyond the influence or control of farmers or, indeed, of anyone else in Northern Ireland. That point has been recognised in the debate by some Members. Moreover, the problems are not unique to Northern Ireland. Given the situation, it is clear that a strategic approach is vital to addressing the problems and challenges that exist now and that will exist in the coming years. It is simply unrealistic to hope that a piecemeal approach or one single initiative will solve the problems of the industry and underpin its future viability.
I agree with many of the points made by Mr Savage and, indeed, have already taken forward initiatives in most of the areas that he mentioned. I thank Mr Bradley for his recognition of that and assure him that I will continue to advance those initiatives. However, I take issue with some of the detailed facts and figures quoted by Mr Savage. Nevertheless, I agree with him on the need for a 10-year plan with which to chart the way forward for the industry.
Indeed, the development of such a plan has been a priority of mine since day one. Members will be aware of the vision exercise that I initiated immediately after I took office in December 1999. The progress of my work was interrupted by a two-and-a-half-month suspension and then by the outbreak of foot-and-mouth disease last year. Nevertheless, the direct result of the exercise was the publication in October 2001 of the vision group’s final report, which made over 200 separate recommendations covering the actions and responsibilities of both the Government and the agriculture industry.
Since then, my Department and I have been engaged in an extensive consultation process with interested stakeholders. In addition, I have held bilateral discussions with almost 30 stakeholder organisations. My Department received over 80 written responses during the consultation process. I would like to record my disappointment that Mr Savage’s party, the Ulster Unionist Party, did not respond in any way to the recommendations contained in the vision group’s report during the consultation process. Moreover, it is surprising that Mr Savage made no mention of the vision exercise in his opening remarks, yet he spent some time dealing with the recommendations of the Curry Report — a report which deals specifically with England and not with Northern Ireland. The vision group’s report, however, deals exclusively with the needs and priorities in Northern Ireland.
(Mr Speaker in the Chair)
During the vision consultation process, the vision approach was generally accepted, although there were several differences of opinion on specific recommendations, some of which I will have to attempt to resolve. Taking account of the consultation, I am now working on an action plan. The full plan will be published in June, but I have decided to accept for implementation now several measures that gained broad support in the consultation exercise and which can be implemented within existing departmental resources.
These measures include setting up focus farms to facilitate farmer competence development; information and communications technology training and development; and off-farm training and reskilling to address underemployment in agriculture, which deals with Mr Shannon’s point about the need to skill farmers to enable them to take up other employment.
In addition, there will be group-based learning approaches; a commercial horticulture strategic review; and enhanced controls to prevent the introduction of animal diseases. An all-Ireland animal and plant health policy will also be taken forward. That is already an agreed aspiration for animal health under the North/South Ministerial Council, which will consider plant health shortly.
Enhanced resources will be devoted to the detection and prevention of fraud, and there will be an individual animal standstill policy, based on 30 days rather than the 21 days recommended by the vision group. A working group will be set up to assess the need for a food body, as recommended in the report. Finally, there will be an independent evaluation of the Erne Catchment Nutrient Management Scheme.
Mr Douglas mentioned nitrate-vulnerable zones (NVZs). Those are a matter for the Department of the Environment, not for my Department. The evaluation will enable us to assess how we can bring forward further plans to deal with other areas. Those areas will be decided on in the light of advice from the Department of the Environment as to where the greatest dangers of pollution are.
My Executive Committee Colleagues endorsed those proposals at their meeting on 28 February. That is precise evidence of the collective approach endorsed by Mr Savage in his opening remarks.
By the end of June, I hope to launch the complete vision action plan, which will provide a road map for the strategic development of the industry over the coming decade. It will also form the centrepiece of my Department’s ongoing programme to assist and promote the sustainable development of the agrifood industry and the rural community that it underpins. However, I must emphasise that the vision exercise is a joint exercise between the Government and the agriculture industry. Almost 40 of the recommendations are for the industry itself to implement, and I will be expecting it to respond to them.
There is a significant amount of interest in the EU’s early retirement scheme and the new entrants scheme as a means of bringing about structural change and introducing new blood into the industry. Mr Savage raised that, as did Mr Armstrong and several other Members. I have certainly not ruled out the possibility of running such schemes in Northern Ireland.
However, questions have been raised about the ability of such schemes to deliver tangible and significant benefits for the efficient development of the industry. With the limited funds at my disposal, I must be satisfied that an early retirement scheme or a new entrants scheme would deliver value for money and that they would represent a better investment in the future of the industry than would alternatives. On that point, Mr McHugh and Mr Douglas placed a question mark over the early retirement scheme.
An initial review by consultants of the operation of the early retirement and new entrants schemes in other EU member states was inconclusive with regard to accruing structural improvements. For that reason I commissioned research into the potential economic, social and environmental benefits that might flow from such schemes. The results of that research will be available in the summer, and I will then be in a position to make an informed decision on the merits of introducing any such schemes into Northern Ireland. The Danish scheme to which Mr Savage referred is geared to meet Denmark’s specific problem of farm succession. My understanding is that successors must purchase holdings from their parents or compensate siblings who are entitled to equal shares of their parents’ assets. There are no such inheritance restrictions in Northern Ireland; the Danish scheme is therefore not appropriate to our circumstances.
I noted Mr Kane’s assertion of a defeatist attitude. I absolutely refute the suggestion that my Department or I might be defeatist in our approach to the problems of the agrifood industry. Were that true, I would not have embarked on the vision group exercise, which is geared to meeting head-on the challenges to which Dr Birnie referred. They are outside our control, but must be met proactively, as must the opportunities they also represent.
Mr McCarthy raised several specific questions about the vision group exercise and my response to its recommendations. I have already indicated the areas that I intend to progress immediately. I still have to consider many more recommendations, including budgetary demands. I will be in a position to publish my full action plan in June. Meanwhile, I thank Mr McCarthy for the initial remarks in his speech.
The vision group exercise is not the only initiative that I have advanced to help the agrifood industry. The rural development regulation plan represents a substantial investment in the future of the agriculture industry in Northern Ireland. More than £266 million will be spent between 2000 and 2006 on sustaining farming in less favoured areas, on supporting agrienvironment measures, including organic farming and on grant-assisting the afforestation of agricultural land. That presents a significant opportunity for farmers and landowners and is a further example of my Department’s commitment to underpinning the sustainable development of our agriculture industry.
With regard to agrienvironment schemes, Mr McHugh raised the issue of environmental sustainability. In the rural development regulation plan, my Department commits considerable resources to such measures as environmentally sensitive areas schemes, an organic farming scheme and a countryside management scheme. Over the seven years of the rural development regulation plan, expenditure on those schemes will total some £88 million, which is double the amount spent in the preceding seven years.
Mr Douglas raised the issue of E-Plan funding for the environmentally sensitive areas scheme. I will keep that area under review, and if funding can be secured, I will reopen the issue at the earliest opportunity.
Mr Douglas also referred to nitrate-vulnerable zones. The Department of the Environment must implement the requirements of the EU’s anti-pollution Directives, and that implementation is many years overdue. The legislation has already been implemented in GB. I appreciate fully the concerns of farmers, and particularly their wish to avoid disproportionate costs. My officials are in close contact with their counterparts in the Department of the Environment to seek proportionate implementation in line with good science and objective data. I am briefed fully and in discussion with ministerial Colleagues on this.
Mr Douglas mentioned agricultural pollution and its prevention; DARD is committed to reducing pollution of that nature. The Department provides advice and training on good farming practice and has secured £6·1million from the Executive programme funds for a farm waste- management scheme that is currently awaiting EU state aid approval.
Mr Douglas also raised the matter of agrimonetary compensation. I have always pressed — with considerable success — for the full payment of all available agrimonetary compensation. However, the compensation mechanism expired at the end of December2001, so there is no possibility of further compensation packages being triggered as a result of currency movements. There is, however, a possibility that residual second and third tranches of previously triggered compensation packages may be available in the dairy, beef and sheep sectors. We will not know the position on this until the EU makes its assessment, which is expected in April.
Mr McHugh and DrBirnie raised the common agricultural policy (CAP). The forthcoming mid-term review of the Agenda2000 agreement is yet another of the many challenges that the farming community faces and a further source of uncertainty. We do not yet know the extent of the changes that the EU Commission will propose later this year. The CAP is facing significant pressures arising from events such as the enlargement of the EU and the World Trade Organisation (WTO) talks, to which DrBirnie referred.
We cannot simply ignore those matters in the hope that they will go away. Nor can we ignore the fears, needs and aspirations of the agriculture industry and the rural society that it underpins. My officials and I are engaged in discussions with our counterparts from the other devolved Administrations and Whitehall on the UK’s approach to the forthcoming mid-term review. Northern Ireland’s interests are being clearly articulated, and we are stressing the importance of keeping the needs of agricultural and rural communities to the fore.
We cannot prevent change, nor should we want to, but we must manage it in such a way that the industry has the time and help that it needs to adapt to and exploit the opportunities that change inevitably brings. We must avoid marginalising and alienating sections of the rural community and undermining the stability and viability of the rural economy.
MrMcGrady and MrPoots mentioned brucellosis, and MrMcGrady spoke about tuberculosis (TB). I am fully aware that brucellosis and TB continue to be serious problems in Northern Ireland. A review of all aspects of the control measures for both diseases is currently under way and should be completed soon. The review group is considering what additional or different measures might be deployed to reduce the incidence of those diseases. As MrMcGrady noted, economic viability and economic and environmental sustainability demand that the industry adapt to reflect the changing demands of the market place and the farmers’ increasingly important role as custodians of the countryside.
Because of the continuous need for change, investing in and developing the skills and education of people in the industry must be a key part of any strategy for sustainable development and viability for the agrifood industry and rural economy. Therefore, through the Department of Agriculture and Rural Development colleges, I have continued to invest in developing education programmes and facilities, with a particular emphasis on lifelong learning for those who already work in the industry. I noted MrArmstrong’s comments on biomass, and I agree that there is potential for a cross-departmental approach to waste.
Mr Shannon spoke about initiatives to promote tourism. He will be aware of the natural resource rural tourism programme, which is now on-stream, and of the support that is available for developing rural tourism. He also raised the issue of planning regulations. The vision group’s report recommends that planning regulations be examined. That too is a cross-departmental issue, as the Department of Agriculture and Rural Development does not have sole responsibility for them. However, I am very conscious of the matter.
The UK Government are working hard to ensure that other EU countries comply with welfare standards, thus creating a level playing field.
I hope that I have given some indication of the broad range of measures that I am already pursuing to enhance further the future viability of Northern Ireland’s agriculture industry. It is important that those measures are integrated into an overall strategy, and that is what I hope to achieve when I launch my full vision action plan in June.
As I have already said, there is no point in reacting to issues as they arise or in dealing piecemeal with the industry — strategic action is required. The vision action plan will be a strategy devised to develop the industry over the next 10 years. It will maintain the viability of rural areas and the farming community in a way that meets the challenges and the opportunities ahead. Rather than ignore those challenges, we must manage and exploit them to our advantage. It is only through working together to a common strategic agenda that the industry can secure its future survival and prosperity.

Mr George Savage: I thank the Minister for giving up her afternoon to participate in the debate. As with all agriculture debates in the House, there have been many valuable contributions from all sides. The Minister has already dealt with many of the issues raised, to which I shall add my contribution.
As Mr Bradley also said, I emphasise that I in no way denigrate the Minister’s efforts. I have the greatest respect for her, and I shall support her in any way that I can. However, taking action in one area does not meet the need for action in other areas. The Minister has done a good job during a crisis, and her management and skills, and those of her officials, leave us confident in and satisfied with her work.
I welcome Mr Kane’s support. His analysis of the powerful world pressures on commodity prices and his call for the Department to devise a recovery strategy are issues that we must all bear in mind, issues that are near and dear to our hearts.
I welcome Mr McHugh’s support for the motion and his constructive remarks on the pressures that drive young people off the land and on the future of localised markets. I also welcome his realistic approach to the failures of the scheme that operates in the Republic. We do not want to go down that route, although I emphasise that our proposed scheme is very different from that in the Republic. Our scheme is modelled closely on those employed in other countries that are part and parcel of Europe. We are also part of Europe, so we have much in common with those other countries.
I cannot accept Mr McCarthy’s comment that the motion is premature. The Minister will respond to the vision group’s report in her own way. She will respond to that report alone, not to the early retirement scheme proposal. I have warned of the dangers of adopting a bitty approach to our agriculture problems. The Committee for Agriculture and Rural Development deals with pressing issues from week to week, and the Assembly must take strategic decisions and look at the bigger picture.
I welcome Mr Douglas’s support and his remarks on the use of modulation money to advance many of the schemes. My Colleague Dr Birnie made useful comments on the relative economic importance of agriculture to our economy and on the need for common agricultural policy reform. It is especially welcome when an Assembly Member who does not represent a rural area speaks in an agriculture debate. Farmers sometimes feel that our Assembly and Parliaments are cold houses for them.
Sometimes people do have much time for these debates, because they think that farmers are only interested in getting their own ends. I assure Members that farmers only want to produce the best in whatever sector their outlets might be.
5.30pm
The House needs to get a handle on these issues if it is to implement the schemes. As the Minister realises, people are coming through our agricultural colleges. There is no use educating people if you have no job for them, and the Department has to take this seriously. If there is no agriculture industry here, there is no call for you people. This is one thing that we are serious about.

Mr Speaker: I remind the Member that when he says "you people", he is referring to the Speaker. It may be that he does not want to change the remark.

Mr George Savage: I apologise, Mr Speaker. I do not mean to denigrate you in anyway.

Mr John Fee: On a point of order, Mr Speaker. The Member might have been accurate in what he said.

Mr Speaker: No doubt, there might be plenty of support for it in the Chamber.

Mr George Savage: I welcome the comments of Mr Poots and especially his demand for innovative thinking, which is at the heart of the matter. I acknowledge Mr M Murphy’s comments of support. I welcome the comments of my Colleague, Mr Armstrong, on a 10-year agriculture plan for recruiting young people into farming by developing alternative income sources and the need for the Assembly to take the lead in developing that policy. Mr Shannon’s account of the decline in farming from real life examples is right, and it is time to take stock. Now is the time to act, when we have a period of relative calm without an immediate crisis.
Although acknowledging all these contributions, it is important not to lose sight of the real reason for the motion. Many serious points have been raised here today, and I know that the Minister is a listening Minister. She takes on board what we try to put across, and I am putting things to her as I see them. We must take things seriously.
When we emerge from this period of recession I would like to see a thriving agriculture industry. As the Minister said, this can only come about with everybody’s help. Although my party may not have responded to one point that she made — and we may have overlooked that — I assure her that it is very much in the thoughts of all our people.
Another important matter that was raised today is the health and safety of our industry. If we can keep Northern Ireland disease-free, we have a future, and everybody has to play a part to ensure that happens. I thank the Minister again for giving up her afternoon. We may not see eye to eye on many issues, but ultimately we have something in common — we want to see a thriving agriculture industry in Northern Ireland. I thank Members for their support. I hope that the points raised will bear fruit in the days to come.
Question put and agreed to.
Resolved:
That this Assembly urges the Minister of Agriculture and Rural Development and the Executive to consider the implementation of measures which will sustain the viability of the agriculture industry in Northern Ireland.
Adjourned at 5.34 pm.